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Enigma of cerebrospinal fluid dynamics.

Klarica M, Orešković D - Croat. Med. J. (2014)

View Article: PubMed Central - PubMed

Affiliation: Marijan Klarica, Department of Pharmacology and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia, marijan.klarica@mef.hr.

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Cerebrospinal fluid (CSF) is a major part of the central nervous system (CNS) extracellular fluid, and fine regulation of its composition is vital to the brain’s health... According to the traditional hypothesis, CSF is formed inside the brain ventricles, mostly by secretion from the choroid plexuses, and it circulates along the ventricles and subarachnoid space to be absorbed across the arachnoid villi into the dural venous sinuses, and/or viacranial and spinal nerves paraneural sheaths into the lymphatic system... The emerging concept of CSF physiology described as microcirculatory/microvessel hypothesis suggests that CNS microvessels are instrumental in fluid filtration and reabsorption inside the brain and spinal cord parenchyma, as well as inside the CSF system... It is important to emphasize that microcirculatory/microvessel hypothesis interconnects the physiology of all craniospinal fluids (plasma, intracellular, extracellular, and cerebrospinal fluid)... Serotonin is very quickly metabolized after its passage from CSF into the brain tissue and its metabolite 5-HIAA quickly disappears from the site of its formation... He showed that serotonin did not distribute inside the CSF and that its lumbar CSF concentration merely reflected the changes inside the surrounding spinal cord tissue... Namely, the 5-HIAA concentration changes after its application into the cisterna magna did not influence its concentration inside the lumbar subarachnoid space... However, based on the classic hypothesis of CSF physiology, increased concentration inside the lumbar subarachnoid space would be reasonably expected... As he noticed that an increase in metabolic transformation inside the spinal cord tissue led to an increase in the concentration inside the surrounding CSF, he concluded that the changes of 5-HIAA concentration inside the lumbar CSF reflected only the local metabolism inside the spinal cord tissue... According to the generally accepted hypothesis, the CSF is secreted inside the brain ventricles and flows unidirectionally along the subarachnoid spaces to be absorbed into the dural venous sinuses... In his fight against the conventional notions, Prof... Bulat found inspiration and strenght in the thought of Claude Bernard, one of the most distinguished physiologists and medical scientists of the nineteenth century: ”When we meet a fact which contradicts a prevailing theory, we must accept the fact and abandon the theory, even when the theory is supported by great names and generally accepted. ” He never gave up, and he managed to show his students and colleagues the way to persevere in science... He passed on this difficult task to all of us who are now, together with our foreign colleagues, trying to save that flame of science and to pass it on to new generations... Instead of conclusion let's thank Prof. emeritus Marin Bulat with another famous sentence by Claude Bernard: “A man of science rises ever, in seeking truth; and if he never finds it in its wholeness, he discovers nevertheless very significant fragments; and these fragments of universal truth are precisely what constitutes science. ”

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A blackboard in Prof. Bulat's study after many hours of discussion about the dynamics of cerebrospinal fluid and other intracranial fluids.
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Figure 2: A blackboard in Prof. Bulat's study after many hours of discussion about the dynamics of cerebrospinal fluid and other intracranial fluids.

Mentions: Due to the importance of his reserch for disputing the traditional CSF physiology hypothesis, we dedicate a part of this editorial to the work of Prof. emeritus Marin Bulat (1936-2012), who started the CSF physiology research in Croatia (Figure 1, Figure 2).


Enigma of cerebrospinal fluid dynamics.

Klarica M, Orešković D - Croat. Med. J. (2014)

A blackboard in Prof. Bulat's study after many hours of discussion about the dynamics of cerebrospinal fluid and other intracranial fluids.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4157379&req=5

Figure 2: A blackboard in Prof. Bulat's study after many hours of discussion about the dynamics of cerebrospinal fluid and other intracranial fluids.
Mentions: Due to the importance of his reserch for disputing the traditional CSF physiology hypothesis, we dedicate a part of this editorial to the work of Prof. emeritus Marin Bulat (1936-2012), who started the CSF physiology research in Croatia (Figure 1, Figure 2).

View Article: PubMed Central - PubMed

Affiliation: Marijan Klarica, Department of Pharmacology and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia, marijan.klarica@mef.hr.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Cerebrospinal fluid (CSF) is a major part of the central nervous system (CNS) extracellular fluid, and fine regulation of its composition is vital to the brain’s health... According to the traditional hypothesis, CSF is formed inside the brain ventricles, mostly by secretion from the choroid plexuses, and it circulates along the ventricles and subarachnoid space to be absorbed across the arachnoid villi into the dural venous sinuses, and/or viacranial and spinal nerves paraneural sheaths into the lymphatic system... The emerging concept of CSF physiology described as microcirculatory/microvessel hypothesis suggests that CNS microvessels are instrumental in fluid filtration and reabsorption inside the brain and spinal cord parenchyma, as well as inside the CSF system... It is important to emphasize that microcirculatory/microvessel hypothesis interconnects the physiology of all craniospinal fluids (plasma, intracellular, extracellular, and cerebrospinal fluid)... Serotonin is very quickly metabolized after its passage from CSF into the brain tissue and its metabolite 5-HIAA quickly disappears from the site of its formation... He showed that serotonin did not distribute inside the CSF and that its lumbar CSF concentration merely reflected the changes inside the surrounding spinal cord tissue... Namely, the 5-HIAA concentration changes after its application into the cisterna magna did not influence its concentration inside the lumbar subarachnoid space... However, based on the classic hypothesis of CSF physiology, increased concentration inside the lumbar subarachnoid space would be reasonably expected... As he noticed that an increase in metabolic transformation inside the spinal cord tissue led to an increase in the concentration inside the surrounding CSF, he concluded that the changes of 5-HIAA concentration inside the lumbar CSF reflected only the local metabolism inside the spinal cord tissue... According to the generally accepted hypothesis, the CSF is secreted inside the brain ventricles and flows unidirectionally along the subarachnoid spaces to be absorbed into the dural venous sinuses... In his fight against the conventional notions, Prof... Bulat found inspiration and strenght in the thought of Claude Bernard, one of the most distinguished physiologists and medical scientists of the nineteenth century: ”When we meet a fact which contradicts a prevailing theory, we must accept the fact and abandon the theory, even when the theory is supported by great names and generally accepted. ” He never gave up, and he managed to show his students and colleagues the way to persevere in science... He passed on this difficult task to all of us who are now, together with our foreign colleagues, trying to save that flame of science and to pass it on to new generations... Instead of conclusion let's thank Prof. emeritus Marin Bulat with another famous sentence by Claude Bernard: “A man of science rises ever, in seeking truth; and if he never finds it in its wholeness, he discovers nevertheless very significant fragments; and these fragments of universal truth are precisely what constitutes science. ”

Show MeSH