Liquor

Eva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.

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The cerebrospinal fluid is the cerebrospinal fluid - that is, the fluid that circulates in the cerebrospinal fluid spaces of the brain and the spinal canal. It represents an important protection for the brain and the spinal cord. External pressure is weakened by the fluid covering the brain, and overheating of the sensitive central nervous system can be dissipated by the cerebrospinal fluid. Read everything you need to know about liquor!

What is the liquor?

The cerebrospinal fluid is a clear, colorless, protein and cell-poor liquid. An adult has about 130 to 150 milliliters of cerebrospinal fluid. About a quarter of them are located in the ventricles, and three quarters surround the brain and the spinal cord as an enveloping fluid jacket.

The cerebrospinal fluid is formed in the choroid plexus (vein plexuses) by special epithelial cells in the cerebral chambers. Through openings in the III. Ventricle (foramina interventricularia) with connections to the respective lateral ventricle and through the aqueductus cerebri (liquor-containing connection between the ventricles) the liquor then reaches the fourth ventricle. From there it flows through various openings and spaces into the subarachnoid space - the gap-shaped space between the middle meninges (arachnoid) and the inner meninges (pia mater). From here, the CSF flows around the brain as cerebrospinal fluid (cerebral fluid), and the spinal cord as cerebrospinal fluid.

About 500 to 700 milliliters of CSF are newly formed every day. So much of it is absorbed through the granulationes arachnoidales (growths of the arachnoidea) and nerve roots that the total amount of circulating liquor does not exceed 150 to 200 milliliters.

What is the significance of the liquor?

The cerebrospinal fluid is used for the metabolism of the nerve cells in the brain and spinal cord. It is also responsible for their mechanical protection: The liquor protects the sensitive nerve tissue from being deformed by external influences and can ensure rapid pressure equalization in the liquor system. In addition, the cerebrospinal fluid in the brain and spinal cord provides thermal protection.

The cerebrospinal fluid is also the origin of the perilymph. This is the watery fluid in the inner ear.

The connection between the spinal cord and the brain via the liquor space is used therapeutically in spinal or lumbar anesthesia. This is a conduction anesthesia in which the drug enters the subarachnoid space directly through a puncture in the lumbar region.

What problems can liquor cause?

If the spaces in the brain filled with liquor are enlarged at the expense of the brain substance, one speaks of a hydrocephalus. There are two types: internal hydrocephalus, in which the ventricles are dilated, and external hydrocephalus, in which the external cerebrospinal fluid spaces are enlarged. The cause for this can be a cerebrospinal fluid circulation disorder.

When there is an inflammatory process in the brain or spinal cord, the number of white blood cells (leukocytes) in the liquor increases. The doctor can determine this by taking a sample of the cerebrospinal fluid and having it examined in the laboratory (liquor diagnostics). If red blood cells (erythrocytes) are found in the CSF, this indicates subarachnoid hemorrhage (bleeding in the subarachnoid space).

The amount of liquor can be increased, for example, by meningitis, by space-occupying bleeding or tumors, or due to genetic reasons. Then the pressure inside the skull increases and the brain is compressed. The body makes do with vasodilation or an increase in arterial blood pressure to ensure blood flow to the brain.

Doctors refer to the obstruction of normal cerebrospinal fluid circulation as CSF blockade. Possible reasons are bleeding, inflammation, tumors, but also a herniated disc. In the event of a CSF blockage in the ventricle, internal hydrocephalus develops; if the spinal cord is blocked, a paraplegic syndrome develops.

If cerebrospinal fluid leaks from the nose or ear, doctors call it liquorrhea. The reason is usually a skull base fracture.

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