Blood-brain barrier story

Let me tell you a story about nutrients travelling up the bloodstream heading towards the head. Because there is a lots of toxic and harmful substances in the blood normally, those nutrients in it get to the point, where only the smallest of them can actually get after that point. That point is simply called the blood-brain barrier (BBB), and it protects the brain from any of those harmful substances.

One of those nutrients, which actually can get through it quite easily is glucose (simple sugar), the main or almost the only food for the brain and whole nervous system. Moreover, the brain does not have any storage room for glucose, so the steady supply of it is necessary for continuous functioning of basically whole body.

But this story of travelling of glucose into the brain get even more interesting. Before actually getting in, there is a "sort of" a middle ground, where it needs to get first. That middle ground is called cerebrospinal fluid (CSF). In an average adult person, there is around 800-1500ml of that fluid in the whole body. And as a proper middle ground, it has very exact boundaries, so it can be only at certain places.

Four small cavities inside of the brain called ventricles (2 lateral, third, and fourth) are filled with it, and the inner side  of them contains special cells, which produce this fluid. From there, they travel or flow through ducts into so-called subarachnoid space, which covers the whole brain and the spine. Hence the word cerebro (brain) - spinal fluid. Because rates of its production and reabsorbtion into the bloodstream are the same, its volume and pressure stays normally constant.

Ever heard about the fact that our brains are basically floating in the fluid? Well, this is it. It literally floats in this CSF tightly packed in that small subarachnoid space. It helps to absorb any physical blows to the head, along with already mentioned supplying the brain with nutrients. Nice flow diagram shows clearly how and where this CSF travel.

This flow diagram is actually quite clever, because on the left side you can see the names of the spaces or cavities, and on the right side you can see the names of the ducts and other structures involved. Plus, within the subarachnoid space, there is a mixing of blood with CSF going on. So when you sometimes feel like scratching your head, it's probably useful to do it for enhancing this mixing and helping some glucose to get into the brain.

Doctors have been pondering and trying to figure out how to deliver certain substances past the BBB, and they came up with the solution. They created highly concentrated glucose solution containing some desirable substance, and the brain will suck it in all thinking it's all the glucose. This way certain drugs can be administered directly to the brain tissue, which would otherwise never be able to cross the BBB.

Also, the alcohol and certain anesthetics seem to have the same capacity, along with some very small molecules like ions of Na, Cl, K, Ca, Mg, carbon dioxide, and mainly the oxygen. Because despite of the brain being only about 2% of total body weight (about 1300g), it consumes about 20% of oxygen supply by lungs. Pretty busy in there, right?

Only 1-2 minutes of the blood flow interruption into the brain can impair a function of nervous system, and 4 minutes would lead to a pernament damage of the brain. I will close this post with another flow diagram, displaying nicely how the blood and CSF interract. It very simple, so there's no need to explain much in there. Enjoy studying.