Water homeostasis in the brain: Basic concepts

The mammalian CNS is separated from the blood by tight junctions, collectively termed the blood-brain barrier (BBB). This imposes unique features of solvent and water movement into and out of the CNS. The basic equations for water fluxes driven by osmotic gradients are presented. The anatomy of the BBB and the physiology of the transport processes for cerebrospinal fluid production, extracellular fluid production and intercellular water and solute transport are then described. A quantitative analysis of the need for aquaporin-based water movements to accompany the known rates of CSF production is also presented. Finally, the mechanisms and roles of cellular and vasogenic edema in the CNS, especially in relation to aquaporins, are described. (C) 2004 IBRO. Published by Elsevier Ltd. All rights reserved.