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Brain Advance Access published online on February 27, 2006
Brain, 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
Received November 28, 2005
Revised January 24, 2006
Accepted January 27, 2006

Article

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

H. E. Killer 1 *, G. P. Jaggi 2, J. Flammer 3, N. R. Miller 4, and A. R. Huber 5

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

* To whom correspondence should be addressed.
H. E. Killer, E-mail: Killer{at}ksa.ch


  Abstract

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.

Keywords: beta trace protein; cerebrospinal fluid; optic nerve; subarachnoid space.
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