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Article
September 1989

Cerebrospinal Fluid and the Brain Edemas

Author Affiliations

Rochester, NY

 

by Thomas H. Milhorat, 168 pp, $45, New York, NY: Neuroscience Society of New York; 1987.

Arch Neurol. 1989;46(9):942. doi:10.1001/archneur.1989.00520450012002

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Abstract

Based on his long-standing clinical and research interests in cerebrospinal fluid, Dr Milhorat has written this monograph to emphasize the lymphaticlike arrangement of cerebrospinal fluid's pathways.

Some 63 years ago in his address entitled "The Third Circulation and Its Channels," Harvey Cushing asked the following question: "Are there lymph channels in the brain, and, if not, how does the central nervous system dispose of its products of tissue waste?" At that time, it appeared that there was no interstitial space within the central nervous system, so that cerebrospinal fluid was thought to be confined to the subarachnoid space and ventricles. Electron microscopic findings have only recently established that there is a space between the brain's cells and their processes, amounting to some 10% to 15% of its volume. This completes the anatomic circle, allowing fluid to move from the vascular system through this well-established extracellular space, the ventricles, and the

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