2020 Volume 57 Issue 1 Pages 79-85
We herein provide a historical review on the autonomic control of the cerebrospinal fluid (CSF) production. Benedikt (1875) discovered nerve endings on the choroid plexus of the human fourth ventricle, and traced it to the medulla oblongata, probably nucleus ambiguus. Since then, the dual innervation of the choroid plexus with the sympathetic and parasympathetic fibers was confirmed by means of classical histological staining (Stöhr, 1922; von Bakay, 1941; Tsuker, 1947) . Utilizing histofluorescence technique, Edvinsson et al. (1972, 73) proved that the choroid plexus received both adrenergic and cholinergic fibers. Passing route of the parasympathetic nerves, or cholinergic fibers, is unknown. Accumulated physiological studies revealed transient increase in the CSF production after sympathectomy (von Bakay, 1941; Hegedus et al., 1965; Lindvall et al., 1978) , and reduction in the csf production with stimulation of the sympathetic nerves (Dorigotti et al., 1972; Haywood, 1976; Lindvall et al., 1978) . However, conflicting results were shown in regard to the effects of sympathomimetic drugs on the CSF production, while most authors agreed that cholinergic drugs enhanced the CSF production. The reason why the problem is settled to date is because CSF is mixture of fluid from the choroid plexus and fluid from pia mater. The former is under the direct influence of the autonomic nerves, since the choroid plexus is a secretory organ like the sweat glands and the salivary glands. The latter may strongly depend on blood circulation, since water moves only by osmolar gradient between blood and CSF in the pia mater.
