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Reassessment of the pathways responsible for cerebrospinal fluid absorption in the neonate

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Abstract

Objective

In neonatal lambs, the quantitative evidence suggests that a significant volume of cranial CSF drainage is associated with transport along olfactory nerves with absorption primarily into extracranial lymphatics in the paranasal region. Arachnoid granulations appear to be poorly developed at this level of development and their function is unknown. In this report, we tested whether a CSF protein tracer (131I-human serum albumin) could transport directly into the superior sagittal sinus of newborn lambs.

Methods and results

The concentration of the tracer administered into the CSF compartment was measured in the confluence of the intracranial venous sinuses (torcula) and in the peripheral blood (inferior vena cava). Enrichment of the CSF tracer in the cranial venous system was most evident when the CSF-venous sinus pressure gradients approached 20–30 cm H2O.

Conclusion

The data suggests that neonatal CSF can be absorbed directly into the cranial venous system. However, contrary to the classical view, this route may represent an auxiliary system that is recruited to compliment lymphatic transport when intracranial pressures are very high.

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Acknowledgements

The authors wish to thank Ms. Dianna Armstrong and Ms. Beverley Young for technical assistance. This research was funded by a grant from the Canadian Institutes of Health Research (CIHR) and a CIHR/Spina Bifida and Hydrocephalus Association of Canada Doctoral Research Award to C.P.

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Authors and Affiliations

  1. Neuroscience Research, Department of Laboratory Medicine and Pathobiology, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4 N 3M5, Canada

    C. Papaiconomou, A. Zakharov, N. Azizi, J. Djenic & M. Johnston

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  1. C. Papaiconomou
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  2. A. Zakharov
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  3. N. Azizi
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  4. J. Djenic
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  5. M. Johnston
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Corresponding author

Correspondence to M. Johnston.

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Papaiconomou, C., Zakharov, A., Azizi, N. et al. Reassessment of the pathways responsible for cerebrospinal fluid absorption in the neonate. Childs Nerv Syst 20, 29–36 (2004). https://doi.org/10.1007/s00381-003-0840-z

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  • DOI: https://doi.org/10.1007/s00381-003-0840-z

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