Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (681 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A watery fluid that is continuously produced in the choroid plexus and circulates around the surface of the brain; spinal cord; and in the cerebral ventricles.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Cerebrospinal Fluids; Fluid, Cerebrospinal; Fluids, Cerebrospinal; Cerebro Spinal Fluid; Cerebro Spinal Fluids; Fluid, Cerebro Spinal; Fluids, Cerebro Spinal; Spinal Fluid, Cerebro.
Where it fits in the MeSH classification
- Broader topics
- Extracellular Fluid
- See also
- Blood-Brain Barrier
Related concepts
- Choroid Plexus
- Brain
- Spinal Cord
- Cerebral Ventricles
Research landscape
PubMed indexes 20,249 records tagged with the MeSH heading “Cerebrospinal Fluid” (counts retrieved 2026-10-31). 1,593 of them (7.9%) were published from 2020 onward, and the busiest period so far is through 1999 with 11,792 records.
Reviews account for 1,483 records (7.3%) and meta-analyses for 32. Randomized controlled trials number 107 (0.5%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 11,792 |
| 2000-2009 | 3,412 |
| 2010-2019 | 3,452 |
| 2020 onward | 1,593 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 1,483 | 7.3% |
| Meta-analyses | 32 | 0.2% |
| Randomized controlled trials | 107 | 0.5% |
Method: PubMed query "Cerebrospinal Fluid"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in anatomy and physiology
Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Circadian control of brain glymphatic and lymphatic fluid flow | 2020 | Research article Design not recorded in structured metadata | 549 | cc by PMID 32879313 · DOI · PMC7468152 |
| Cerebrospinal fluid outflow: a review of the historical and contemporary evidence for arachnoid villi, perineural routes, and dural lymphatics | 2021 | Review article Design not recorded in structured metadata | 333 | cc by PMID 33427948 · DOI · PMC8004496 |
| Multisensory gamma stimulation promotes glymphatic clearance of amyloid | 2024 | Research article Design not recorded in structured metadata | 324 | cc by PMID 38418876 · DOI · PMC10917684 |
| Photoacoustic computed tomography monitors cerebrospinal fluid dynamics and glymphatic function | 2026 | Research article Design not recorded in structured metadata | 6 | cc by PMID 41680169 · DOI · PMC13009472 |
Circadian control of brain glymphatic and lymphatic fluid flow [1]
Abstract reading summary — source excerpts
- Opening excerpt
- The glymphatic system is a network of perivascular spaces that promotes movement of cerebrospinal fluid (CSF) into the brain and clearance of metabolic waste.
- Closing excerpt
- We conclude that CSF distribution is under circadian control and that AQP4 supports this rhythm.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (149 words)
The glymphatic system is a network of perivascular spaces that promotes movement of cerebrospinal fluid (CSF) into the brain and clearance of metabolic waste. This fluid transport system is supported by the water channel aquaporin-4 (AQP4) localized to vascular endfeet of astrocytes. The glymphatic system is more effective during sleep, but whether sleep timing promotes glymphatic function remains unknown. We here show glymphatic influx and clearance exhibit endogenous, circadian rhythms peaking during the mid-rest phase of mice. Drainage of CSF from the cisterna magna to the lymph nodes exhibits daily variation opposite to glymphatic influx, suggesting distribution of CSF throughout the animal depends on time-of-day. The perivascular polarization of AQP4 is highest during the rest phase and loss of AQP4 eliminates the day-night difference in both glymphatic influx and drainage to the lymph nodes. We conclude that CSF distribution is under circadian control and that AQP4 supports this rhythm.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32879313 · DOI · PMC7468152
Cerebrospinal fluid outflow: a review of the historical and contemporary evidence for arachnoid villi, perineural routes, and dural lymphatics [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Cerebrospinal fluid (CSF) is produced by the choroid plexuses within the ventricles of the brain and circulates through the subarachnoid space of the skull and spinal column to provide buoyancy to and maintain fluid homeostasis of the brain and spinal cord.
- Closing excerpt
- An improved understanding of this fundamental physiological process may lead to novel therapeutic approaches for a wide range of neurological conditions, including hydrocephalus, neurodegeneration and multiple sclerosis.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (244 words)
Cerebrospinal fluid (CSF) is produced by the choroid plexuses within the ventricles of the brain and circulates through the subarachnoid space of the skull and spinal column to provide buoyancy to and maintain fluid homeostasis of the brain and spinal cord. The question of how CSF drains from the subarachnoid space has long puzzled scientists and clinicians. For many decades, it was believed that arachnoid villi or granulations, outcroppings of arachnoid tissue that project into the dural venous sinuses, served as the major outflow route. However, this concept has been increasingly challenged in recent years, as physiological and imaging evidence from several species has accumulated showing that tracers injected into the CSF can instead be found within lymphatic vessels draining from the cranium and spine. With the recent high-profile rediscovery of meningeal lymphatic vessels located in the dura mater, another debate has emerged regarding the exact anatomical pathway(s) for CSF to reach the lymphatic system, with one side favoring direct efflux to the dural lymphatic vessels within the skull and spinal column and another side advocating for pathways along exiting cranial and spinal nerves. In this review, a summary of the historical and contemporary evidence for the different outflow pathways will be presented, allowing the reader to gain further perspective on the recent advances in the field. An improved understanding of this fundamental physiological process may lead to novel therapeutic approaches for a wide range of neurological conditions, including hydrocephalus, neurodegeneration and multiple sclerosis.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33427948 · DOI · PMC8004496
Multisensory gamma stimulation promotes glymphatic clearance of amyloid [3]
Abstract reading summary — source excerpts
- Opening excerpt
- The glymphatic movement of fluid through the brain removes metabolic waste1-4.
- Closing excerpt
- Our findings establish novel mechanisms that recruit the glymphatic system to remove brain amyloid.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (133 words)
The glymphatic movement of fluid through the brain removes metabolic waste1-4. Noninvasive 40 Hz stimulation promotes 40 Hz neural activity in multiple brain regions and attenuates pathology in mouse models of Alzheimer's disease5-8. Here we show that multisensory gamma stimulation promotes the influx of cerebrospinal fluid and the efflux of interstitial fluid in the cortex of the 5XFAD mouse model of Alzheimer's disease. Influx of cerebrospinal fluid was associated with increased aquaporin-4 polarization along astrocytic endfeet and dilated meningeal lymphatic vessels. Inhibiting glymphatic clearance abolished the removal of amyloid by multisensory 40 Hz stimulation. Using chemogenetic manipulation and a genetically encoded sensor for neuropeptide signalling, we found that vasoactive intestinal peptide interneurons facilitate glymphatic clearance by regulating arterial pulsatility. Our findings establish novel mechanisms that recruit the glymphatic system to remove brain amyloid.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 38418876 · DOI · PMC10917684
Photoacoustic computed tomography monitors cerebrospinal fluid dynamics and glymphatic function [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Cerebrospinal fluid (CSF) continuously circulates through the brain and surrounding tissues to remove metabolic waste, a process that becomes less efficient with ageing and in neurodegenerative disease.
- Closing excerpt
- These results establish PACT as a non-invasive platform for measuring CSF and glymphatic function in vivo, providing a way to study how brain fluid transport is altered in ageing and neurological disorders.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (155 words)
Cerebrospinal fluid (CSF) continuously circulates through the brain and surrounding tissues to remove metabolic waste, a process that becomes less efficient with ageing and in neurodegenerative disease. Visualizing this drainage in living animals has been difficult because existing imaging tools either lack depth, require radioactive tracers, or are too slow to capture dynamic flow. Here, we show that whole-body photoacoustic computed tomography (PACT) enables three-dimensional, real-time tracking of CSF transport in mice using indocyanine green. We visualize CSF movement from the spinal canal into the brain, quantify its efflux under different anesthesia conditions, and detect impaired clearance in a mouse model of Alzheimer's disease. Compared with healthy animals, diseased mice retain the tracer in the brain for several days, indicating reduced waste removal. These results establish PACT as a non-invasive platform for measuring CSF and glymphatic function in vivo, providing a way to study how brain fluid transport is altered in ageing and neurological disorders.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41680169 · DOI · PMC13009472
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article The Glymphatic System: A Beginner's Guide [5]
- Research article The blood-brain and the blood-cerebrospinal fluid barriers: function and dysfunction [6]
- Research article Anatomy and physiology of cerebrospinal fluid [7]
- Research article Cerebrospinal fluid secretion by the choroid plexus [8]
- Research article Molecular anatomy and functions of the choroidal blood-cerebrospinal fluid barrier in health and disease [9]
- Research article Choroid plexus and the blood-cerebrospinal fluid barrier in disease [10]
References
- Hablitz LM, Plá V, Giannetto M, Vinitsky HS, Stæger FF, Metcalfe T, et al.. Circadian control of brain glymphatic and lymphatic fluid flow. . 2020. PMID 32879313 · DOI · PMC7468152
- Proulx ST. Cerebrospinal fluid outflow: a review of the historical and contemporary evidence for arachnoid villi, perineural routes, and dural lymphatics. . 2021. PMID 33427948 · DOI · PMC8004496
- Murdock MH, Yang CY, Sun N, Pao PC, Blanco-Duque C, Kahn MC, et al.. Multisensory gamma stimulation promotes glymphatic clearance of amyloid. . 2024. PMID 38418876 · DOI · PMC10917684
- Choi S, Kim J, Jeon H, Lee Y, Lim G, Ju WM, et al.. Photoacoustic computed tomography monitors cerebrospinal fluid dynamics and glymphatic function. . 2026. PMID 41680169 · DOI · PMC13009472
- Jessen NA, Munk AS, Lundgaard I, Nedergaard M. The Glymphatic System: A Beginner's Guide. Neurochem Res. 2015. PMID 25947369 · DOI · PMC4636982
- Engelhardt B, Sorokin L. The blood-brain and the blood-cerebrospinal fluid barriers: function and dysfunction. Semin Immunopathol. 2009. PMID 19779720 · DOI
- Sakka L, Coll G, Chazal J. Anatomy and physiology of cerebrospinal fluid. Eur Ann Otorhinolaryngol Head Neck Dis. 2011. PMID 22100360 · DOI
- Damkier HH, Brown PD, Praetorius J. Cerebrospinal fluid secretion by the choroid plexus. Physiol Rev. 2013. PMID 24137023 · DOI
- Ghersi-Egea JF, Strazielle N, Catala M, Silva-Vargas V, Doetsch F, Engelhardt B. Molecular anatomy and functions of the choroidal blood-cerebrospinal fluid barrier in health and disease. Acta Neuropathol. 2018. PMID 29368213 · DOI
- Solár P, Zamani A, Kubíčková L, Dubový P, Joukal M. Choroid plexus and the blood-cerebrospinal fluid barrier in disease. Fluids Barriers CNS. 2020. PMID 32375819 · DOI · PMC7201396
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-31.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.