Cerebrospinal fluid, or CSF, is a clear, colorless liquid that plays a crucial role in maintaining the health and function of your central nervous system. It cushions the brain and spinal cord, provides nutrients and removes waste products.
Despite its importance, problems related to CSF often go unnoticed until something goes wrong.
Recently, cerebrospinal fluid disorders drew public attention with the announcement that musician Billy Joel had been diagnosed with normal pressure hydrocephalus. In this condition, excess CSF accumulates in the brain’s cavities, enlarging them and putting pressure on surrounding brain tissue even though diagnostic readings appear normal. Because normal pressure hydrocephalus typically develops gradually and can mimic symptoms of other neurodegenerative diseases, such as Alzheimer’s or Parkinson’s disease, it is often misdiagnosed.
I am a neurologist and headache specialist. In my work treating patients with CSF pressure disorders, I have seen these conditions present in many different ways. Here’s what happens when your cerebrospinal fluid stops working.
What is cerebrospinal fluid?
CSF is made of water, proteins, sugars, ions and neurotransmitters. It is primarily produced by a network of cells called the choroid plexus, which is located in the brain’s ventricles, or cavities.
The choroid plexus produces approximately 500 milliliters (17 ounces) of CSF daily, but only about 150 milliliters (5 ounces) are present within the central nervous system at any given time due to constant absorption and replenishment in the brain. This fluid circulates through the ventricles of the brain, the central canal of the spinal cord and the subarachnoid space surrounding the brain and spinal cord.
Cerebrospinal fluid circulates throughout the brain and spinal cord.
OpenStax, CC BY-SA
CSF has several critical functions. It protects the brain and spinal cord from injury by absorbing shocks. Suspending the brain in this fluid reduces its effective weight and prevents it from being crushed under its own mass. Additionally, CSF helps maintain a stable chemical environment in the central nervous system, facilitating the removal of metabolic waste and the distribution of nutrients and hormones.
If the production, circulation or absorption of cerebrospinal fluid is disrupted, it can lead to significant health issues. Two notable conditions are CSF leaks and idiopathic intracranial hypertension.
Cerebrospinal fluid leak
A CSF leak occurs when the fluid escapes through a tear or hole in the dura mater – the tough, outermost layer of the meninges that surrounds the brain and spinal cord.
The dura can be damaged from head injuries or punctured during surgical procedures involving the sinuses, brain or spine, such as lumbar puncture, epidurals, spinal anesthesia or myelogram. Spontaneous CSF leaks can also occur without any identifiable cause.
CSF leaks were originally…
