Choroid plexus
Encyclopedia
The choroid plexus is a structure in the ventricles of the brain where cerebrospinal fluid
Cerebrospinal fluid
Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...

 (CSF) is produced. The choroid plexus consists of modified ependymal cells.

Locations

Choroid plexus is present in all components of the ventricular system
Ventricular system
The ventricular system is a set of structures containing cerebrospinal fluid in the brain. It is continuous with the central canal of the spinal cord.-Components:The system comprises four ventricles:* right and left lateral ventricles* third ventricle...

 except for the cerebral aqueduct
Cerebral aqueduct
The mesencephalic duct, also known as the aqueductus mesencephali, aqueduct of Sylvius or the cerebral aqueduct, contains cerebrospinal fluid , is within the mesencephalon and connects the third ventricle in the diencephalon to the fourth ventricle in the mesencephalon, which is between the pons...

, frontal horn of the lateral ventricle, and occipital horn of the lateral ventricle.

It is found in the superior part of the inferior horn of the lateral ventricles. It follows up along this boundary, continuous with the inferior of the body of the lateral ventricles. It passes into the interventricular foramen, and is present at the top of the third ventricle
Third ventricle
The third ventricle is one of four connected fluid-filled cavities comprising the ventricular system within the human brain. It is a median cleft between the two thalami, and is filled with cerebrospinal fluid ....

.

There is also choroid plexus in the fourth ventricle
Fourth ventricle
The fourth ventricle is one of the four connected fluid-filled cavities within the human brain. These cavities, known collectively as the ventricular system, consist of the left and right lateral ventricles, the third ventricle, and the fourth ventricle...

, in the section closest to the bottom half of the cerebellum
Cerebellum
The cerebellum is a region of the brain that plays an important role in motor control. It may also be involved in some cognitive functions such as attention and language, and in regulating fear and pleasure responses, but its movement-related functions are the most solidly established...

.

Structure of the choroid plexus

The choroid plexus (CP) consists of many capillaries, separated from the ventricles by choroid epithelial cells. Liquid filters through these cells from blood to become cerebrospinal fluid. There is also much active transport
Active transport
Active transport is the movement of a substance against its concentration gradient . In all cells, this is usually concerned with accumulating high concentrations of molecules that the cell needs, such as ions, glucose, and amino acids. If the process uses chemical energy, such as from adenosine...

 of substances into, and out of, the CSF as it is made.

There are four choroid plexi in the brain, one in each of the ventricles. The CP consist of a layer of cuboidal epithelial cells surrounding a core of capillaries and loose connective tissue. The CP epithelial layer is continuous with the ependymal cell layer that lines the ventricles, but unlike the ependyma the CP epithelial layer has tight junctions in between the cells on the side facing the ventricle (apical surface). These tight junctions prevent the majority of substances from crossing the cell layer into the CSF; thus the CP acts as a blood-CSF
Blood-brain barrier
The blood–brain barrier is a separation of circulating blood and the brain extracellular fluid in the central nervous system . It occurs along all capillaries and consists of tight junctions around the capillaries that do not exist in normal circulation. Endothelial cells restrict the diffusion...

 barrier. The CP folds into many villi around each capillary, creating frond-like processes that project into the ventricles. The villi, along with a brush border of microvilli, greatly increases the surface area of the CP. CSF is formed as plasma is filtered from the blood through the epithelial cells. CP epithelial cells actively transport sodium, chloride and bicarbonate ions into the ventricles and water follows the resulting osmotic gradient.

In addition to CSF production, the CP act as a filtration system, removing metabolic waste, foreign substances, and excess neurotransmitters from the CSF. In this way the CP have a very important role in helping to maintain the delicate extracellular environment required by the brain to function optimally.

Pathology

During embryological development, some fetuses may form choroid plexus cysts. These fluid-filled cysts can be detected by a level II ultrasound (18–20 weeks gestation). The finding is relatively common, with a prevalence of ~1%. Choroid plexus cysts (CPC) can be an isolated finding, which confers a 1-12% (variable based on population studied) risk of fetal aneuploidy
Aneuploidy
Aneuploidy is an abnormal number of chromosomes, and is a type of chromosome abnormality. An extra or missing chromosome is a common cause of genetic disorders . Some cancer cells also have abnormal numbers of chromosomes. Aneuploidy occurs during cell division when the chromosomes do not separate...

. The risk of aneuploidy increases to 10.5-12% if other risk factors or ultrasound findings are noted. The idioma size, bilaterality, disappearance/progression of the CPC, and position of the CPC do not have any effect on the risk of aneuploidy. 44-50% of trisomy 18 cases will present with CPC, and 1.4% of trisomy 21 (Down syndrome) cases will present with CPC. ~75% of abnormal karyotypes (obtained by chorionic villus sampling or amniocentesis) associated with CPCs are trisomy 18, while the remainder are trisomy 21.

CPCs typically disappear later during pregnancy, and are considered soft markers. They are likely harmless, and studies have shown that they have no effect on infant and early childhood development.

External links

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