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AJNR Am J Neuroradiol. 1996 Mar;17(3):431-8.

A proposed model of cerebrospinal fluid circulation: observations with radionuclide cisternography.

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1
Department of Neuroradiology, Karolinska Hospital, Stockholm, Sweden.

Abstract

PURPOSE:

To determine the mechanisms of the tracer distribution at radionuclide cisternography (RC).

METHODS:

Ten patients with venous vasculitis were studied with RC. Flow phantom studies were performed mimicking cerebrospinal fluid (CSF) circulation with and without a main outlet comparable to the pacchionian granulations.

RESULTS:

Nine of the 10 patients had normal findings on RC images, including a maximum uptake over the vertex at 24 hours. In all patients, a second maximum occurred in the lumbosacral area. The flow phantom studies showed no tracer accumulation at an open outlet corresponding to the pacchionian granulations. On the contrary, a maximum arose without such an outlet. A maximum always arose at the closed dead ends of the phantom, including the lumbosacral area.

CONCLUSION:

The commonly accepted flow model for CSF circulation needs to be revised. The pattern of the normal RC cannot be explained by a bulk flow transport of the tracer to an outlet at the pacchionian granulations but rather by a primary mixing caused by pulsatile flow with a secondary dilution by newly formed CSF from the ventricular system. We suggest that the main absorption of the CSF is through the central nervous system to the blood.

PMID:
8881235
[Indexed for MEDLINE]
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