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Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review

CSF outflow through the cribriform plate near the olfactory nerves and the outflow along brain and spinal nerves are together known as peripheral CSF outflow pathway (PCOP). It is still not clear whether the PCOP has pathogenetic relevance. Our previous clinical observations have indicated that CSF...

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Detalles Bibliográficos
Autores principales: Bechter, Karl, Schmitz, Bernd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Croatian Medical Schools 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157386/
https://www.ncbi.nlm.nih.gov/pubmed/25165054
http://dx.doi.org/10.3325/cmj.2014.55.399
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author Bechter, Karl
Schmitz, Bernd
author_facet Bechter, Karl
Schmitz, Bernd
author_sort Bechter, Karl
collection PubMed
description CSF outflow through the cribriform plate near the olfactory nerves and the outflow along brain and spinal nerves are together known as peripheral CSF outflow pathway (PCOP). It is still not clear whether the PCOP has pathogenetic relevance. Our previous clinical observations have indicated that CSF may interact with nerves along the PCOP and in this article we present our finding of CSF outflow demonstrated by myelography in a single patient. We also discuss unexplained experimental pain pathomechanisms against the background of the PCOP hypothesis. We observed that CSF flowed along lumbar nerves in distal direction at a speed of about 10 cm per hour on its way through the tissues, mainly muscles. Total CSF outflow volume at the lumbar site was remarkable. CSF outflow at lumbar nerves was also documented by neuroradiology. It is plausible that CSF signaling serves for interaction with nerves along the PCOP, which could explain previously unknown pathomechanisms in pain generation. Experimental findings of tactile pain hypersensitivity within lumbosacral pain pathways could be explained by releasing of molecules, microparticles, or exosomes into the CSF by mast cells, which then move with CSF outflow along the PCOP and interact with nerves, initiating even retrograde synaptic stripping.
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spelling pubmed-41573862014-09-08 Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review Bechter, Karl Schmitz, Bernd Croat Med J Case Report CSF outflow through the cribriform plate near the olfactory nerves and the outflow along brain and spinal nerves are together known as peripheral CSF outflow pathway (PCOP). It is still not clear whether the PCOP has pathogenetic relevance. Our previous clinical observations have indicated that CSF may interact with nerves along the PCOP and in this article we present our finding of CSF outflow demonstrated by myelography in a single patient. We also discuss unexplained experimental pain pathomechanisms against the background of the PCOP hypothesis. We observed that CSF flowed along lumbar nerves in distal direction at a speed of about 10 cm per hour on its way through the tissues, mainly muscles. Total CSF outflow volume at the lumbar site was remarkable. CSF outflow at lumbar nerves was also documented by neuroradiology. It is plausible that CSF signaling serves for interaction with nerves along the PCOP, which could explain previously unknown pathomechanisms in pain generation. Experimental findings of tactile pain hypersensitivity within lumbosacral pain pathways could be explained by releasing of molecules, microparticles, or exosomes into the CSF by mast cells, which then move with CSF outflow along the PCOP and interact with nerves, initiating even retrograde synaptic stripping. Croatian Medical Schools 2014-08 /pmc/articles/PMC4157386/ /pubmed/25165054 http://dx.doi.org/10.3325/cmj.2014.55.399 Text en Copyright © 2014 by the Croatian Medical Journal. All rights reserved. http://creativecommons.org/licenses/by/2.5/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Bechter, Karl
Schmitz, Bernd
Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review
title Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review
title_full Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review
title_fullStr Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review
title_full_unstemmed Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review
title_short Cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review
title_sort cerebrospinal fluid outflow along lumbar nerves and possible relevance for pain research: case report and review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157386/
https://www.ncbi.nlm.nih.gov/pubmed/25165054
http://dx.doi.org/10.3325/cmj.2014.55.399
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