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Choroid Plexus: Source of Cerebrospinal Fluid and Regulator of Brain Development and Function

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Pediatric Hydrocephalus

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Abstract

Thomas Willis in 1664 suggested that the cerebral ventricles contain fluid produced by the choroid plexus, but this was not established until the 19th century. Dandy and Blackfan produced experimental hydrocephalus and reported that choroid plexus (CP) ablation decreased its severity; this strongly implicated CP in generating CSF and ventricular pressure. Choroid plexuses produce most cerebrospinal fluid (CSF), proteins, and small molecules, regulate the entry of ions and vitamins into the central nervous system, and have immunological and endocrine regulatory functions. CP is the single most important brain-immune interface; the CSF is its channel of communication with the brain. Substantial loss of CP may harm CSF-brain biochemical interactions. Early attempts to control human hydrocephalus by CP ablation produced poor outcomes. Currently, however, combined choroid plexus coagulation (CPC) and endoscopic third ventriculostomy (ETV) are used for resolving infant hydrocephalus and protecting brain against elevated ICP. Still, does addition of CPC to ETV significantly improve long-term outcomes? How does the brain compensate, if it does, for loss of CP homeostatic mechanisms involving endocrine and immunologic phenomena? Clinical studies of CPC should examine possible effects on synaptic plasticity, neurogenesis, and cognition.

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Author information

Authors and Affiliations

  1. Department of Neurology and Pediatrics, School of Medicine, UCLA, Torrance, CA, USA

    Robert Snodgrass

  2. Department of Neurosurgery, Alpert Medical School, Brown University, Providence, RI, USA

    Conrad E. Johanson

Authors
  1. Robert Snodgrass
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  2. Conrad E. Johanson
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Corresponding author

Correspondence to Robert Snodgrass .

Editor information

Editors and Affiliations

  1. Pediatric Neurosurgery, Santobono Pausilipon Children’s Hospital, Naples, Italy

    Giuseppe Cinalli

  2. Division of Pediatric Neurosurgery, Acıbadem University, School of Medicine, Istanbul, Istanbul, Turkey

    M. Memet Ozek

  3. Hopital Necker-Enfants Malades, Paris, France

    Christian Sainte-Rose

Section Editor information

  1. Department of Neurosurgery, Division of Pediatric Neurosurgery, Washington University in St. Louis, St. Louis, MO, USA

    Pat McAllister

  2. Department of Pediatric Neurosurgery, Santobono-Pausilipon Children’s Hospital, Naples, Italy

    Giuseppe Cinalli

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Snodgrass, R., Johanson, C.E. (2018). Choroid Plexus: Source of Cerebrospinal Fluid and Regulator of Brain Development and Function. In: Cinalli, G., Ozek, M., Sainte-Rose, C. (eds) Pediatric Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-319-31889-9_38-1

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  • DOI: https://doi.org/10.1007/978-3-319-31889-9_38-1

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  • Print ISBN: 978-3-319-31889-9

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