The optic nerve: a new window into cerebrospinal fluid composition?

• Published in: Brain (London, England : 1878) Vol. 129; no. 4; pp. 1027 - 1030
• Main Authors: Killer, H. E., Jaggi, G. P., Flammer, J., Miller, N. R., Huber, A. R.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2006; Oxford Publishing Limited (England)
• Subjects: Adult; beta trace protein; Biological and medical sciences; Biomarkers - blood; Biomarkers - cerebrospinal fluid; cerebrospinal fluid; Cerebrospinal Fluid - physiology; Cerebrospinal Fluid Pressure; Cranial nerves. Peripheral nerves. Autonomic nervous system; CSF = cerebrospinal fluid; Female; Humans; Immunoglobulin G - blood; Immunoglobulin G - cerebrospinal fluid; Injuries of the nervous system and the skull. Diseases due to physical agents; Intramolecular Oxidoreductases - cerebrospinal fluid; Lipocalins; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; MRI = magnetic resonance imaging; Neurology; Neurosurgery; NSE = neuron-specific enolase; ON = optic nerve; ONSF = optic nerve sheath fenestration; optic nerve; Optic Nerve - ultrastructure; Optic Nerve Diseases - cerebrospinal fluid; Optic Nerve Diseases - pathology; Optic Nerve Diseases - physiopathology; PGD = prostaglandin D; SAS = subarachnoid space; Serum Albumin - analysis; Serum Albumin - cerebrospinal fluid; Specimen Handling - methods; Spinal Puncture; subarachnoid space; Subarachnoid Space - ultrastructure; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Traumas. Diseases due to physical agents; Nervous system diseases; Optic nerve; Visual pathway; subarachnoid space; Subarachnoid; Windows; Cerebrospinal fluid; beta trace protein; Protein
• ISSN: 0006-8950; 1460-2156
• DOI: 10.1093/brain/awl045

Cerebrospinal fluid (CSF) pressure and composition are generally thought to be homogeneous within small limits throughout all CSF compartments. CSF sampled during lumbar puncture therefore should be representative for all CSF compartments. On the basis of clinical findings, histology and biochemical markers, we present for the first time strong evidence that the subarachnoid spaces (SAS) of the optic nerve (ON) can become separated from other CSF compartments in certain ON disorders, thus leading to an ON sheath compartment syndrome. This may result in an abnormal concentration gradient of CSF molecular markers determined in locally sampled CSF compared with CSF taken during lumbar puncture.