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Open Access

A new look at cerebrospinal fluid circulation

  • Thomas Brinker1Email author,
  • Edward Stopa1,
  • John Morrison1 and
  • Petra Klinge1
Fluids and Barriers of the CNS201411:10

DOI: 10.1186/2045-8118-11-10

Received: 23 January 2014

Accepted: 18 April 2014

Published: 1 May 2014

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Archived Comments

  1. Experimental hydrocephalus

    7 May 2014

    Darko Lavrencic, MED zasebna splosna ambulanta

    I have a comment in regard to the following statement in the article: “However, the novel concepts are also challenged mainly by the lack of validated supporting data. For example, Klarica et al. failed to reproduce the historical experiments of Dandy, since no circulation of CSF was found along a plastic cannula introduced into the aqueduct of cats.«

    In the article by Dandy and Blackfan, which you cite, it is said »a piece of cotton in a small gelatin capsule … into the aqueduct of Sylvius, where it is deposited. «

    In the article by Oreskovic, Klarica and Vukic ( here I would like to point out the correct order of authors as opposed to “Klarica, Oreskovic and Vukic” used in the article), which you cite, it is said  “A plastic cannula was introduced into the aqueduct of Sylvius through the vermis cerebelli and the outflow of CSF from the cannula was used as the CSF formation and circulation index” (also described in other similar articles by the above authors).

    Dandy and Blackfan blocked CSF flow in the aqueduct of Sylvius, while Oreskovic, Klarica and Vukic allowed CSF flow in the aqueduct of Sylvius through cannula. Can we assume that both experimental methods are the same?

    If the release of freshly actively formatted CSF happens during diastole when brain and choroid plexus shrink and create relative negative pressure in brain ventricles, this could explain hydrocephalus in Dandy and Blackfan experiment. For the comment on Oreskovic, Klarica and Vukic experiment, please see my on-line comment (Lavrencic 2013).

    References:

    Lavrencic, D. D. (2013). "During which phase of cardiac cycle is freshly actively formatted (FAF) cerebrospinal fluid (CSF) released into the brain ventricles: systole or diastole?". Retrieved 30 April 2013, from  http://www.med-lavrencic.si/download/Lavrencic_CSF_release_cardiac_cycle.pdf

    Competing interests

    The author declares that no conflict of interest exists.
  2. Response to the comment of Lavrencic D.D.

    7 May 2014

    Thomas Brinker, Neurosurgery Foundation Providence

    Dear colleague Lavrencic,

    Thank you for your comment. The statement you refer to does not compare the methods of the experiments of Dandy and Klarica and his group, instead it compares the experimental results; experiments of the former author indicate an aqueductal CSF flow, while the results of the latter authors showed the absence of such a flow. The paper is correctly cited in the reference section. Klarica was named at this point since he is obviously the senior author, present in each of the pubmed listed publications of the Zagreb based CSF research group.

    Competing interests

    None

Authors’ Affiliations

(1)
Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital

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