According to the current understanding, the production of CSF is from multiple sources, primarily from the choroid plexus of the lateral and fourth ventricles. The currently accepted CSF flow system comprises pulsatile CSF flow, lymphatic system, capillary exchange, and the traditional ventricular-cisternal system. However, this model seems inadequate to explain the pathophysiological mechanisms of various CSF flow-related disorders based on recent literature. The traditional concept of CSF formation, distribution, and absorption was previously based on the bulk flow model. It also predisposes the brain and spinal cord to the external environment increasing the risk of meningitis, ventriculitis, and arachnoiditis. Such conditions might be associated with fractures in the skull base, congenital bony defects, or might be associated with raised intracranial pressure (ICP). In various disorders that present with CSF leak, the loss of this protective nutrient-rich layer can injure the function of the brain and the spinal cord. This protective cushion circulates within the ventricular system and the subarachnoid space around the brain and the spinal cord, which helps to provide the buoyancy to counteract various shear and stress encountered during the movement of the skull and vertebral column. The cerebrospinal fluid (CSF) acts as a nourishing and protective layer surrounding the central nervous system.
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