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Croatian medical journal, Vol.55 No.4 August 2014. -

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.



Autor: Karl Bechter - ; Department of Psychiatry and Psychotherapy II, Ulm University- Bezirkskrankenhaus Guenzburg Guenzburg, Germany B

Fuente: http://hrcak.srce.hr/



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