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Trauma Research Program, Department of Laboratory Medicine and Pathobiology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada M4N 3M5
In this study, we quantified cerebrospinal fluid
(CSF) transport from the cranial and spinal subarachnoid spaces
separately in sheep and determined the relative proportion of total CSF
drainage that occurred from both CSF compartments. Cranial and spinal
CSF systems were separated by placement of an extradural ligature over
the spinal cord between C1 and C2. In one
approach, two different radiolabeled human serum albumins (HSA) were
introduced into the appropriate CSF compartment by a perfusion system
(method 1) or as a bolus injection (method 2).
Plasma tracer recoveries in conjunction with a mass balance equation
were used to estimate CSF transport. In method 3, catheters
connected to reservoirs filled with artificial CSF were introduced into
the cranial and spinal CSF compartments. Incremental CSF pressures were
established in each CSF system, and the corresponding steady-state flow
rates were measured. Total CSF drainage ranged from 0.51 to 0.75 ml · h
1 · cmH2O1.
Expressed as a percentage of the total CSF transport, the ratios of
cranial-to-spinal clearance estimated from methods 1, 2, and 3 were 75:25, 88:12, and 75:25, respectively. Primarily on
the basis of the data derived from methods 1 and
3, we conclude that the spinal subarachnoid compartment has
an important role in CSF clearance and is responsible for approximately
one-fourth of total CSF transport.
cerebrospinal fluid pressure; spinal cord; brain; arachnoid villi; lymphatic vessels; cribriform plate; cerebrospinal fluid outflow resistance; cerebrospinal fluid conductance
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