CSF Pathway
Obstruction &
Clinical correlates
Integrated Teaching session for 1st MBBS
Department of Neurosurgery
MGMCRI
CSF pathway
Lateral ventricles,Third Ventricle, Fourth Ventricle
CSF pathway – FormationCSF pathway
Formation: Choroid plexus
• Lateral
ventricles
• Third
ventricle
• Fourth
ventricle
CSF pathway
Formation: Choroid plexus
CSF pathway
Formation: Choroid plexus
CSF production
is an active
process – ATP
is spent
CSF pathway
Lateral ventricles-> Third Ventricle
CSF pathwayCSF pathway
Fourth Ventricle -> Subarachnoid space
CSF pathway
Spinal Subarachnoid space
CSF pathwayCSF pathway
CSF resorption: Arachnoid granulations
CSF pathway
CSF resorption: Arachnoid granulations
CSF pathway
Monro-Kelly Doctrine
Normal ICP:
5-15 mm Hg
Raised ICP:
> 20 mm Hg
CSF pathway
Hydrocephalus
MRI of normal ventricles MRI of dilated ventricles
CSF pathway
Hydrocephalus - Adult
Headache
Vomiting
Altered sensorium
Diplopia
CSF pathway
Hydrocephalus - Child
Macrocephaly
Persistent AF – Bulging
Sun setting sign
Hydrocephalus
Treatment – Ventriculoperitoneal shunt
Hydrocephalus
Treatment – Endoscopic Third Ventriculostomy

2016.03.16 csf pathway abnormalities