Identification of a novel path for cerebrospinal fluid (CSF) drainage of the human brain

How cerebrospinal fluid (CSF) drains from the human brain is of paramount importance to cerebral health and physiology. Obstructed CSF drainage results in increased intra-cranial pressure and a predictable cascade of events including dilated cerebral ventricles and ultimately cell death. The current...

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Bibliographic Details
Published in:PloS one 2023-05, Vol.18 (5), p.e0285269-e0285269
Main Author: Pessa, Joel E
Format: Article
Language:English
Subjects:
Analysis
Anatomy
Biology and Life Sciences
Brain
Brain - physiology
Carotid arteries
Cell death
Cerebral ventricles
Cerebrospinal fluid
Cerebrospinal Fluid - physiology
Cerebrospinal Fluid Leak
Channels
Cranial Sinuses
Dissection
Drainage
Fluorescence
Fluoroscopy
Humans
Medical research
Medicine and Health Sciences
Nervous system
Research and Analysis Methods
Sinuses
Skull
Subarachnoid Space
Surgical drains
Travel
Veins
Veins & arteries
Ventricles (cerebral)
Wound drainage
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Summary:How cerebrospinal fluid (CSF) drains from the human brain is of paramount importance to cerebral health and physiology. Obstructed CSF drainage results in increased intra-cranial pressure and a predictable cascade of events including dilated cerebral ventricles and ultimately cell death. The current and accepted model of CSF drainage in humans suggests CSF drains from the subarachnoid space into the sagittal sinus vein. Here we identify a new structure in the sagittal sinus of the human brain by anatomic cadaver dissection. The CSF canalicular system is a series of channels on either side of the sagittal sinus vein that communicate with subarachnoid cerebrospinal fluid via Virchow-Robin spaces. Fluorescent injection confirms that these channels are patent and that flow occurs independent of the venous system. Fluoroscopy identified flow from the sagittal sinus to the cranial base. We verify our previous identification of CSF channels in the neck that travel from the cranial base to the subclavian vein. Together, this information suggests a novel path for CSF drainage of the human brain that may represent the primary route for CSF recirculation. These findings have implications for basic anatomy, surgery, and neuroscience, and highlight the continued importance of gross anatomy to medical research and discovery.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0285269