Cerebrospinal fluid flow. I. Physiology of cardiac-related pulsation.

Cardiac-related motion of the cerebrospinal fluid (CSF) was investigated by analysis of the velocity-dependent phase of CSF protons and flow-dependent signal enhancement in magnitude images using ECG-gated FLASH sequences. In the cerebral aqueduct, CSF flow from the third to the fourth ventricle begins 200 ms after the R-wave of the ECG and simulates an arterial pulse wave pattern. It lasts about 60% of the cardiac cycle and is followed by backflow from the fourth to the third ventricle, which is slower and shorter. In the spinal canal, oscillating caudad motion precedes flow from the third to the fourth ventricle by about 50-100 ms and is superimposed on a bulk flow, which moves simultaneously in opposite directions in separate subarachnoid channels; it is directed mainly caudally in the anterior cervical subarachnoid space.