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New Findings and Concepts on Production and Absorption of Cerebrospinal Fluid: Reconsiderations and Revisions of an Unquestioningly Accepted Dogma of 100 Years Takahiko Tokuda 1 , Shinya Kida 2 1Department of Molecular Pathobiology of Brain Diseases, Kyoto Prefectural University of Medicine 2Department of Neurosurgery, Fukui Prefectural Hospital Keyword: bulk flow説 , 脳脊髄液 , 脳間質液 , 毛細血管説 , 脳リンパ排液 , bulk flow theory , cerebrospinal fluid , brain interstitial fluid , capillary theory , brain lymphatic drainage pp.617-626
Published Date 2015/5/1
DOI https://doi.org/10.11477/mf.1416200190
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Abstract

It has been recently pointed out that there are fallacies in the bulk flow theory, a dogmatic idea of cerebrospinal fluid (CSF) physiology, which assumes that CSF is produced by the choroid plexus and circulates unidirectionally from the ventricles to the subarachnoid space to be absorbed by the arachnoid villi in the parietal region. Therefore, CSF physiology now needs to be reconsidered. Since there is free exchange of water between the CSF and the brain interstitial fluid (ISF), when considering the dynamics of water in the brain, we should regard these two fluid compartments collectively as brain extracellular fluid. In this review, I discuss the contentious issues in the traditional theory of CSF physiology, and then introduce new understandings of the production and absorption of the brain extracellular fluid, such as the capillary theory asserting that brain ISF is produced and absorbed mainly at the cerebral capillaries, the brain lymphatic drainage pathway, and the non-existence of unidirectional CSF circulation.


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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