NUEVOS CONCEPTOS SOBRE EL LÍQUIDO CEFALORRAQUÍDEO: EL SISTEMA GLINFÁTICO

The traditional model of cerebrospinal fluid hydrodynamics has been questioned since its conception. In that model, the cerebrospinal fluid is secreted in the choroid plexus of cerebral ventricles, then flows to the subarachnoid space just to be reabsorbed into the dural sinuses via arachnoid villi. Now we know that the interstitial fluid is in contact with the cerebrospinal fluid of subarachnoid space, and it can be an important source of production of the latter. We also know that 50% of cerebrospinal fluid goes to the cervical lymphatics via cribriform plate. The Virchow-Robin spaces and the aquaporin 4 of pericapillary astrocytes form an important system for the circulation of cerebral interstitial fluid. This pathway is now known as the glymphatic system and it plays an important role in certain neurodegenerative diseases and cerebral edema.