The ventricular system of the brain: a comprehensive review of its history, anatomy, histology, embryology, and surgical considerations

Mortazavi, Martin M.; Adeeb, Nimer; Griessenauer, Christoph J.; Sheikh, Hina A; Shahidi, Seyed Houtan; Tubbs, Richard Isaiah; Tubbs, R. Shane

doi:10.1007/s00381-013-2321-3

Cited by 76 publications

(49 citation statements)

References 94 publications

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“…Since tracers injected into the cisterna magna did not enter the ventricular system, our data are consistent with the prevailing view that CSF flows along the ventricular system, reaches the subarachnoid space via the foramen of Magendie, and subsequently enters the subarachnoid space in the cisterna magna (Fig. 8 ) [ 33 ]. The relevance of this drainage pathway for removal of β-amyloid and other waste products remains to be explored.…”

Section: Discussionsupporting

confidence: 90%

Clearance from the mouse brain by convection of interstitial fluid towards the ventricular system

Bedussi

Lier

Bartstra

et al. 2015

Fluids Barriers CNS

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BackgroundIn the absence of a true lymphatic system in the brain parenchyma, alternative clearance pathways for excess fluid and waste products have been proposed. Suggested mechanisms for clearance implicate a role for brain interstitial and cerebrospinal fluids. However, the proposed direction of flow, the anatomical structures involved, and the driving forces are controversial.MethodsTo trace the distribution of interstitial and cerebrospinal fluid in the brain, and to identify the anatomical structures involved, we infused a mix of fluorescent tracers with different sizes into the cisterna magna or striatum of mouse brains. We subsequently performed confocal fluorescence imaging of horizontal brain sections and made 3D reconstructions of the mouse brain and vasculature.ResultsWe observed a distribution pattern of tracers from the parenchyma to the ventricular system, from where tracers mixed with the cerebrospinal fluid, reached the subarachnoid space, and left the brain via the cribriform plate and the nose. Tracers also entered paravascular spaces around arteries both after injection in the cisterna magna and striatum, but this appeared to be of minor importance.ConclusionThese data suggest a bulk flow of interstitial fluid from the striatum towards the adjacent lateral ventricle. Tracers may enter arterial paravascular spaces from two sides, both through bulk flow from the parenchyma and through mixing of CSF in the subarachnoid space. Disturbances in this transport pathway could influence the drainage of amyloid β and other waste products, which may be relevant for the pathophysiology of Alzheimer’s disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12987-015-0019-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Clearance from the mouse brain by convection of interstitial fluid towards the ventricular system

Bedussi

Lier

Bartstra

et al. 2015

Fluids Barriers CNS

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“…The columns of the fornix form the inferior portion of the medial wall. [6][7][8] The body of the lateral ventricle communicates with the atrium posteriorly from the foramina of Monro to the corpus callosum and psalterium of the fornix, also called the hippocampal commissure. The roof is formed by the body of the corpus callosum, and the floor is formed by the thalamus.…”

Section: Lateral Ventriclesmentioning

confidence: 99%

The Lateral Ventricles: A Detailed Review of Anatomy, Development, and Anatomic Variations

Scelsi

Rahim

Morris

et al. 2020

AJNR Am J Neuroradiol

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The cerebral ventricles have been studied since the fourth century BC and were originally thought to harbor the soul and higher executive functions. During the infancy of neuroradiology, alterations to the ventricular shape and position on pneumoencephalography and ventriculography were signs of mass effect or volume loss. However, in the current era of high-resolution cross-sectional imaging, variation in ventricular anatomy is more easily detectable and its clinical significance is still being investigated. Interpreting radiologists must be aware of anatomic variations of the ventricular system to prevent mistaking normal variants for pathology. We will review of the anatomy and development of the lateral ventricles and discuss several ventricular variations.

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“…The thinnest portion is the anterior portion of the floor of the third ventricle extending from the infundibulum to the premamillary sulcus. 31 In fact, during operative endoscopic third ventriculostomies, thinning of the anterior floor of the third ventricle has been observed. 21 All reported cases of STVs have been in the context of obstructive hydrocephalus and are thought to be associated with chronic increased ICP.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Third Ventriculostomy in Krabbe Disease

Zuccoli

Kim

Poe

et al. 2020

Pediatric Neurology

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a b s t r a c tIntroduction: Spontaneous third ventriculostomies have been reported in relation to obstructive hydrocephalus and increased intracranial pressure and are most commonly seen as disruption of the floor of the third ventricle. Hydrocephalus has been reported in patients with Krabbe disease; however, it is clinically difficult to monitor for hydrocephalus in patients with Krabbe disease as symptoms of increased intracranial pressure may overlap with symptoms of Krabbe disease. We describe a case series of spontaneous third ventriculostomy and hydrocephalus, likely in response to increased intracranial pressure, in patients with infantile Krabbe disease. Methods: Brain magnetic resonance images of patients with infantile Krabbe disease were retrospectively analyzed to assess for ventricular size and presence of spontaneous third ventriculostomies. A brain atlas was used to standardize the calculation of ventricular size. Mid-sagittal, T2-weighted images around the third ventricle were assessed for spontaneous third ventriculostomies. Developmental outcomes were measured with a series of standardized and validated tests. Results: Seventy-five patients with infantile Krabbe disease were evaluated. Twelve cases of spontaneous third ventriculostomies were identified. Head circumference (SE ¼ 8.07; P < 0.001) and average ventricular volume were greater (left: SE ¼ 1.47, P < 0.001) in patients with spontaneous third ventriculostomies when compared with patients without spontaneous third ventriculostomies. Patients with spontaneous third ventriculostomies also had more delayed development in adaptive (difference ¼ 0.2, P < 0.01), gross motor (difference ¼ 0.0, P < 0.01), and fine motor (difference ¼ 0.1, P < 0.001) function. Conclusions: Spontaneous third ventriculostomies, likely in the context of increased intracranial pressure, were identified in patients with Krabbe disease. Although difficult to assess, our study highlights the importance of monitoring for increased intracranial pressure, which can result in spontaneous third ventriculostomies, in patients with infantile Krabbe disease.

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The ventricular system of the brain: a comprehensive review of its history, anatomy, histology, embryology, and surgical considerations

Abstract: Herein, we summarize the literature about the cerebral ventricular system.

Cited by 76 publications

References 94 publications

Clearance from the mouse brain by convection of interstitial fluid towards the ventricular system

Clearance from the mouse brain by convection of interstitial fluid towards the ventricular system

The Lateral Ventricles: A Detailed Review of Anatomy, Development, and Anatomic Variations

Spontaneous Third Ventriculostomy in Krabbe Disease

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