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Brain Advance Access originally published online on February 27, 2006
Brain 2006 129(4):1027-1030; doi:10.1093/brain/awl045
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© The Author (2006). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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

H. E. Killer1,2, G. P. Jaggi2, J. Flammer1, N. R. Miller4 and A. R. Huber3

1 University of Basel, Eye Institute, 2 Department of Ophthalmology and 3 Department of Laboratory Medicine, Kantonsspital Aarau, Switzerland and 4 Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA

Correspondence to: PD Dr. H.E. Killer, Kantonsspital Aarau, CH-5001 Aarau, Switzerland E-mail: Killer{at}ksa.ch

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.

Key Words: beta trace protein; cerebrospinal fluid; optic nerve; subarachnoid space

Abbreviations: CSF = cerebrospinal fluid; ON = optic nerve; SAS = subarachnoid space; ONSF = optic nerve sheath fenestration; MRI = magnetic resonance imaging; PGD = prostaglandin D; NSE = neuron-specific enolase

Received November 28, 2005. Revised January 24, 2006. Accepted January 27, 2006.


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