Ventricular System - Flow of Cerebrospinal Fluid

Flow of Cerebrospinal Fluid

The ventricles are filled with cerebrospinal fluid (CSF) which bathes and cushions the brain and spinal cord within their bony confines. Cerebrospinal fluid is produced by modified ependymal cells of the choroid plexus found in all components of the ventricular system except for the cerebral aqueduct and the posterior and anterior horns of the lateral ventricles. CSF flows from the lateral ventricles via the foramina of Monro into the third ventricle, and then the fourth ventricle via the cerebral aqueduct in the brainstem. From there it can pass into the central canal of the spinal cord or into the cisterns of the subarachnoid space via three small foramina: the central foramen of Magendie and the two lateral foramina of Luschka.

The fluid then flows around the superior sagittal sinus to be reabsorbed via the arachnoid villi into the venous system. CSF within the spinal cord can flow all the way down to the lumbar cistern at the end of the cord around the cauda equina where lumbar punctures are performed.

The aqueduct between the third and fourth ventricles is very small, as are the foramina, which means that they can be easily blocked, causing high pressure in the lateral ventricles. This is a common cause of hydrocephalus (known colloquially as "water on the brain"), which is an extremely serious condition due to both the damage caused by the pressure as well as nature of whatever caused the block (e.g. a tumour or inflammatory swelling). The cavities of the cerebral hemispheres are called lateral ventricles, or 1st & 2nd ventricles. These two ventricles open commonly into the 3rd ventricle by a common opening called the foramen of Monro.

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