The classic theory states that the choroid plexi are the primary sources of CSF production. Several theories have been proposed to explain how CSF is produced. The fluid is a mixture of water, proteins at low concentrations, ions, neurotransmitters, and glucose that is renewed three to four times per day ( Damkier et al., 2013 Hladky and Barrand, 2014 Spector et al., 2015). The CSF is a clear, colorless fluid that occupies the ventricular system, the cerebral and spinal subarachnoid spaces, and the perivascular spaces in the CNS. This will provide the basis for highlighting the knowledge gaps that should be addressed through further research. This review aims to describe the theories underlying the CSF system in relation to neurological diseases in the brain and spinal cord. Of utmost importance is bridging the knowledge gap between the brain and the spinal cord regarding the controversies of a glymphatic system and a lymphatic network, and further to understanding how these complex relationships in the CSF system contribute to health and disease. Yet, some aspects of the CSF system remain to be fully clarified, notably along the spinal cord. The CSF system constitutes a crucial role in the CNS as it provides mechanical protection, ensures homeostasis, and facilitates communication between the CNS and peripheral nervous system, lymphatic system, vascular system, and immune system ( Damkier et al., 2013 Aspelund et al., 2015 Louveau et al., 2015 Adigun and Al-Dhahir, 2021). Renewed attention has come to the cerebrospinal fluid (CSF) system due to its importance for central nervous system (CNS) homeostasis. This review briefly summarizes the CSF system and its implications for CNS diseases and highlights the knowledge gaps that require further research. Yet, several aspects remain to be fully clarified, notably along the spinal cord as the preponderance of research has focused on the brain. In recent years, extensive research has resulted in vastly improved understanding of the CSF system in health and disease. The system of CSF refers to all components involved in CSF production, movement, and absorption.

3Comparative Medicine Lab, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, DenmarkĪ comprehensive understanding of the cerebrospinal fluid (CSF) system is essential for our understanding of health and disease within the central nervous system (CNS).

2Department of Biomedicine, Faculty of Health, Aarhus University, Aarhus, Denmark.

1Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.

Thea Overgaard Wichmann 1*, Helle Hasager Damkier 2 and Michael Pedersen 3 Post lumbar puncture headache: diagnosis and management. Headache after an epidural or spinal anaesthetic.

International Classification of Headache Disorders 3rd Edition.

Headache pain worsens when coughing, sneezing or straining.

Headache pain that increases when sitting or standing.

Intense dull or throbbing headache that starts in the front or back of the head.

Usually, it occurs within 1 to 2 days after the spinal tap.

What are the signs and symptoms of a spinal headache?Ī spinal headache develops within 5 days after a spinal tap. These problems include a ruptured (burst) cyst on the spinal cord and a head or face injury such as a fractured skull. Other conditions can cause spinal fluid leaks that lead to spinal headaches.

The surrounding nerves and tissues become stretched, which results in the headache. The loss of fluid reduces the fluid balance surrounding the brain, which causes the brain to sag downward. Sometimes, spinal fluid leaks out of the tiny hole created by the needle. Doctors use this procedure to diagnose illness and deliver anesthesia, such as when pregnant women have an epidural during childbirth.Īrea of lower spine where spinal tap is taken and close-up of needle in the spinal canal.ĭuring the lumbar puncture, a doctor inserts a needle into the spinal canal in the lower back to deliver anesthesia or withdraw a sample of cerebrospinal spinal fluid. The most common cause of a spinal headache is a puncture (hole) created during a procedure called a spinal tap or lumbar puncture.

Spinal fluid