Cerebrospinal Fluid and Craniocervical Instability
In this section, the following topics will be covered:
- Anatomy and Glymphatic System Basics
- Cerebrospinal Fluid (CSF) and the Brain
- Cerebrospinal Fluid and Craniocervical Instability
- What is Hydrocephalus?
- Medical Investigation of CSF Abnormalities
- With Craniocervical Instability, what may help improve CSF flow to the Brain?and Other Conservative Management Suggestions*
1. Anatomy and Glymphatic System Basics
2. Cerebrospinal Fluid (CSF) and the Brain
The brain is surrounded by a protective fluid called cerebrospinal fluid (CSF). CSF is critical in the brain’s lymphatic system, called the glymphatic system and it allows for the removal of waste products from the brain.
CSF is produced in the center of the brain and is very important to the health and protection of the brain. CSF provides the brain with protection from shock and injury such as falls and head injuries. It is also responsible for delivering nutrients to the brain from the bloodstream. Not only does it provide nutrients but it plays a major role in clearing out waste between the nerve cells of the brain. CSF gently flows throughout the entire brain and spinal cord before being reabsorbed into the circulatory system.
CSF has a gentle pumping flow pattern that pumps with each beat of your heart. The fluid will circulate around the brain and down the spinal cord in a particular flow pattern. The flow is not noticeable under normal circumstances. This flow can however, be disrupted and cause turbulence much like a rough river bed that cause rapids to the flow of a river.
A significant cause of this turbulent CSF flow is a misalignment of the craniocervical junction (upper neck). A misalignment to the head and neck can twist or torque the covering over the spinal cord (called dura matter) and cause the fluid to pulsate around the brain more heavily. This pounding turbulence is linked to “pounding or pulsating headaches” and multiple neurodegenerative conditions including multiple sclerosis.
3. Cerebrospinal Fluid and Craniocervical Instability
In some rare instances, the brainstem and misaligned craniocervical junction can cause a partial blockage of CSF flow causing a back up of CSF. This blockage occurs commonly with people who have Arnold-Chiari malformations, especially if they also have an upper cervical misalignment. It can also occur in individuals who have had traumatic whiplash-like injuries that have pulled the spinal cord and brainstem down.
When CSF flow is blocked at the craniocervical junction, the fluid can back up and increase pressure in the cranium (i.e. head) and can be linked to hydrocephalus (“water on the brain”) and ventriculomegaly. This backed up CSF can lead to migraines and pain behind the eyes. If the fluid is not draining properly, waste products from the brain can accumulate which can slow down cognitive function. If left long enough, it can progress to more severe conditions such as hydrocephalus and neurodegeneration, including demential type symptoms.
4. Medical Investigation of CSF Abnormalities
- CSF Flow Study
- Dynamic MRI Cineloop Flexion-Extension
- Lumbar Puncture
- More coming soon!
5. What is Hydrocephalus?
“Hydrocephalus comes from the Greek words: “Hydro” meaning water and “cephalus” meaning head. Hydrocephalus is a chronic, neurological condition caused by an abnormal accumulation of cerebrospinal fluid (CSF) within cavities of the brain called ventricles, resulting in pressure on the brain. It affects over 1 million Americans, ranging from infants and older children to young and middle-aged adults, as well as seniors. There is currently no cure for hydrocephalus, but it can be treatable.” Reference.
6. With Craniocervical Instability, what may help improve CSF flow to the Brain?
- Upper Cervical Chiropractors may help correct the misalignment of the upper cervical spine that can improve CSF flow through the brain and down the spinal cord. By improving CSF flow, the nerves are able to calm down and heal. Correcting the misalignment can improve pressure regulation by allowing the fluid to drain and filter correctly.
Other Conservative Management Suggestions*
Note: *discuss options with your treating physicians before trying the following suggestions.
- Exercise at least 30 minutes a day, such as walking, aqua-fitness or walking in water (note: the pressure of the water pushes more blood up and into the brain and water is gentle on the body/joints). If you are bed-bound, disregard this, we completely understand.
- Drink enough water daily (i.e. 11 cups daily for women and 15 cups for men)
- Daily gentle neck stretches in the morning and nighttime as recommended by a PT or Upper Cervical Chiropractor
- Proper Body Postures as recommended by an Occupational Therapist
- Upper Cervical Chiropractic NUCCA, Atlas-Orthogonal or Blair
- Physiotherapy (PT)
- Diet – Eat foods that improve brain health like 1 cup berries, leafy greens, walnuts, pumpkin seeds, omega-3, tumeric, coconut and avocados.
- Talk to your physician about appropriate surgery options
SBA Ref. Revive UCC