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Cerebrospinal fluid physiology: visualization of cerebrospinal fluid dynamics using the magnetic resonance imaging Time-Spatial Inversion Pulse method.

Yamada S - Croat. Med. J. (2014)

Bottom Line: Previously there have been no methods for directly tracing the flow of cerebrospinal fluid (CSF) under physiological conditions, and the circulation of CSF has therefore been studied and visualized by injecting a radioactively labeled tracer or contrast medium visible in x-ray images.The CSF dynamics visualized using Time-SLIP has been found to differ markedly from the classical CSF circulation theory described in medical textbooks.Obtaining a more accurate understanding of normal CSF physiology and pathophysiology should lead to improved diagnostic accuracy, permit the identification of new etiological factors in a variety of diseases, and promote the development of new therapeutic approaches.

View Article: PubMed Central - PubMed

Affiliation: Shinya Yamada, Division of Neurosurgery, Toshiba Rinkan Hospital, 7-9-1 Kamitsuruma, Sagamihara, Kanagawa 252-0385, Japan, shinyakoro@gmail.com.

ABSTRACT
Previously there have been no methods for directly tracing the flow of cerebrospinal fluid (CSF) under physiological conditions, and the circulation of CSF has therefore been studied and visualized by injecting a radioactively labeled tracer or contrast medium visible in x-ray images. The newly developed Time-Spatial Inversion Pulse (Time-SLIP) method makes it possible to directly visualize the flow of CSF using magnetic resonance imaging (MRI), permitting CSF dynamics to be depicted in a certain time frame. The CSF dynamics visualized using Time-SLIP has been found to differ markedly from the classical CSF circulation theory described in medical textbooks. It can be said that research on CSF dynamics has advanced to the next stage with the use of this innovative imaging method. Obtaining a more accurate understanding of normal CSF physiology and pathophysiology should lead to improved diagnostic accuracy, permit the identification of new etiological factors in a variety of diseases, and promote the development of new therapeutic approaches.

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Midsagittal view of a normal volunteer showing turbulent cerebrospinal fluid flow in the third ventricle with the head stationary (arrow). Supplementary video 6.
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Figure 6: Midsagittal view of a normal volunteer showing turbulent cerebrospinal fluid flow in the third ventricle with the head stationary (arrow). Supplementary video 6.

Mentions: CSF motion in the third and fourth ventricles is swirling vortex-type flow even when the head is stationary (Figure 6). The area around the third ventricle contains a dense arrangement of vital structures that are related to the circadian rhythm. It has recently become possible to directly observe the inner surface of the ventricles by opening a small hole in the brain and inserting an endoscope (17). Due to remarkable improvements in spatial resolution, the visualization capabilities are completely different from those in the past. It is now possible to insert an endoscope into the third ventricle by advancing it from the lateral ventricle through the foramen of Monro after opening a small hole in the brain. We can see capillaries running from the pituitary gland in the anterior direction. Exposed red-colored blood vessels can be seen in the wall of the third ventricle. Although this may be a rather unfamiliar concept, a new theory of volume transmission involving hormonal transmitters (eg, orexin, prostaglandin D) has been proposed in contrast to the so-called neurotransmission in the form of synaptic transmission (18-21). This involves hormonal transmission, which functions in a manner similar to internal secretion in the blood. Volume transmission is thought to transmit signals to surrounding tissues by means of hormonal transmitters (ie, paracrine system in the central nervous system). The mechanism by which the CSF transports hormonal transmitters and allows their interaction via the CSF is referred to as CSF signaling (20). This mechanism transmits signals over a considerable distance, for example from the pineal body to the pituitary gland. The turbulence and swirling CSF flow in the third ventricle (10), should have some functional significance in terms of CSF signaling, which can be referred to as the CSF paracrine system.


Cerebrospinal fluid physiology: visualization of cerebrospinal fluid dynamics using the magnetic resonance imaging Time-Spatial Inversion Pulse method.

Yamada S - Croat. Med. J. (2014)

Midsagittal view of a normal volunteer showing turbulent cerebrospinal fluid flow in the third ventricle with the head stationary (arrow). Supplementary video 6.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4157376&req=5

Figure 6: Midsagittal view of a normal volunteer showing turbulent cerebrospinal fluid flow in the third ventricle with the head stationary (arrow). Supplementary video 6.
Mentions: CSF motion in the third and fourth ventricles is swirling vortex-type flow even when the head is stationary (Figure 6). The area around the third ventricle contains a dense arrangement of vital structures that are related to the circadian rhythm. It has recently become possible to directly observe the inner surface of the ventricles by opening a small hole in the brain and inserting an endoscope (17). Due to remarkable improvements in spatial resolution, the visualization capabilities are completely different from those in the past. It is now possible to insert an endoscope into the third ventricle by advancing it from the lateral ventricle through the foramen of Monro after opening a small hole in the brain. We can see capillaries running from the pituitary gland in the anterior direction. Exposed red-colored blood vessels can be seen in the wall of the third ventricle. Although this may be a rather unfamiliar concept, a new theory of volume transmission involving hormonal transmitters (eg, orexin, prostaglandin D) has been proposed in contrast to the so-called neurotransmission in the form of synaptic transmission (18-21). This involves hormonal transmission, which functions in a manner similar to internal secretion in the blood. Volume transmission is thought to transmit signals to surrounding tissues by means of hormonal transmitters (ie, paracrine system in the central nervous system). The mechanism by which the CSF transports hormonal transmitters and allows their interaction via the CSF is referred to as CSF signaling (20). This mechanism transmits signals over a considerable distance, for example from the pineal body to the pituitary gland. The turbulence and swirling CSF flow in the third ventricle (10), should have some functional significance in terms of CSF signaling, which can be referred to as the CSF paracrine system.

Bottom Line: Previously there have been no methods for directly tracing the flow of cerebrospinal fluid (CSF) under physiological conditions, and the circulation of CSF has therefore been studied and visualized by injecting a radioactively labeled tracer or contrast medium visible in x-ray images.The CSF dynamics visualized using Time-SLIP has been found to differ markedly from the classical CSF circulation theory described in medical textbooks.Obtaining a more accurate understanding of normal CSF physiology and pathophysiology should lead to improved diagnostic accuracy, permit the identification of new etiological factors in a variety of diseases, and promote the development of new therapeutic approaches.

View Article: PubMed Central - PubMed

Affiliation: Shinya Yamada, Division of Neurosurgery, Toshiba Rinkan Hospital, 7-9-1 Kamitsuruma, Sagamihara, Kanagawa 252-0385, Japan, shinyakoro@gmail.com.

ABSTRACT
Previously there have been no methods for directly tracing the flow of cerebrospinal fluid (CSF) under physiological conditions, and the circulation of CSF has therefore been studied and visualized by injecting a radioactively labeled tracer or contrast medium visible in x-ray images. The newly developed Time-Spatial Inversion Pulse (Time-SLIP) method makes it possible to directly visualize the flow of CSF using magnetic resonance imaging (MRI), permitting CSF dynamics to be depicted in a certain time frame. The CSF dynamics visualized using Time-SLIP has been found to differ markedly from the classical CSF circulation theory described in medical textbooks. It can be said that research on CSF dynamics has advanced to the next stage with the use of this innovative imaging method. Obtaining a more accurate understanding of normal CSF physiology and pathophysiology should lead to improved diagnostic accuracy, permit the identification of new etiological factors in a variety of diseases, and promote the development of new therapeutic approaches.

Show MeSH
Related in: MedlinePlus