Cerebro spinal fluid dynamics and the blood-brain barrier

Abstract

Cerebrospinal fluid (CSF) accounts for 10% of intracranial volume. It protects the brain and the spinal cord; it also carries nutrients and metabolites and facilitates the distribution of central nervous system acting drugs. CSF is mainly produced by the choroid plexuses and resorbed by the arachnoid villi. Its secretion is associated with the transport of ions and water at the blood-brain and blood-CSF barriers. Its circulation is related to cardiac and respiratory frequencies. Intracraneal pressure (ICP) is dependent on those processes and it is affected in several pathologies. The changes in CSF dynamics may be physiologically compensated; however, many drugs (such as anesthetics) may alter those dynamics. Those mechanisms should be taken into account to avoid adverse effects during drug administration, but they may also be considered to manage ICP alterations in several disorders.