There is fluid in the brain

Removal of cerebrospinal fluid (liquor)

Author: Dr. med. habil. Gesche Tallen, created on: October 29th, 2009, editing: Maria Yiallouros, approval: Prof. Dr. med. Dr. H. c. Günter. Henze, last changed: 04.06.2020

The brain and spinal cord are very sensitive tissues that are always bathed in a liquid to protect them and also to supply them with nutrients. This fluid is called the cerebrospinal fluid, cerebrospinal fluid, or cerebrospinal fluid. The liquor flows in a space between the different meninges (or spinal cord membranes), which extends from the cerebrum to the lower spinal cord in the lumbar spine.

If the brain or spinal cord or meninges or spinal cord membranes are affected by cancer or an infection, this can be proven by examining the cerebrospinal cord fluid.

Children's drawing for lumbar puncture

Liquor can be withdrawn using a lumbar puncture or a ventricular puncture.

The parents can be present during both procedures to give the child comfort and calm and, according to the doctor's instructions, to help with the correct positioning of the child. Both lumbar and ventricular punctures are quick interventions, after which patients usually rarely complain of discomfort. In rare cases, a headache occurs. However, this can be prevented if the patient lies down for a while (one to two hours) after the puncture.

Lumbar or ventricular punctures are mainly performed in the diagnosis and treatment of:

Cerebrospinal fluid withdrawal from the lumbar region (lumbar puncture)

With a lumbar puncture, the doctor, usually under local anesthesia, pierces the nerve water canal with a very fine and long hollow needle between two vertebrae of the lumbar spine. This is where the space containing the cerebrospinal fluid (liquor) can best be reached. Medicines (cytostatics) can also be injected at this point as part of a treatment. From there, they are distributed throughout the entire liquor space.

The patient is punctured either while sitting or lying on the side. After the puncture, he usually has to lie head-down for some time (about two hours) so that no headaches occur. If a medication is administered, lying down also serves to better distribute this medication in the CSF space.

Collection of cerebrospinal fluid from a cerebral ventricle (ventricular puncture)

During a ventricular puncture, cerebral spinal cord fluid (liquor) is removed via a brain chamber (cerebral ventricle) or, as part of a treatment, a cytostatic is administered into a brain chamber. A drug administered in this way can then spread throughout the entire CSF space. The ventricular puncture is performed using a so-called Rickham reservoir or Ommaya reservoir, which has previously been implanted by neurosurgery. During the ventricular puncture, the child can sit or lie down.

CSF examinations

For which questions can the examination of the cerebrospinal fluid be important? More information here