CSF Flow and the Upper Cervical Spine (C1 and C2)

The upper cervical spine and the role of CSF is not a very well understood area by the medical community.

The basic jobs of CSF flow are to keep the brain buoyant, provides nutrition to the brain and remove metabolic waste products.

Mechanisms of continuous secretion and reabsorption of CSF effectively maintain intracranial (pressure in the skull) and intrathecal (pressure in the membrane surrounding the nervous system) pressure equilibrium. Contents of the skull, blood and CSF must coexist in a state of dynamic equilibrium where the change in volume of one must require the change in volume of either one of both others. Any increase in total volume of cranial contents must result in elevated intracranial pressure.

Misalignment in the upper cervical spine 

If a misalignment occurs in the upper cervical spine, it can affect this flow. CSF stasis has been associated with vertebral subluxation causing mechanical cord tension, reduced cranial rhythmic impulse and restricted respiratory function. However, evidence suggests that CSF stasis may occur commonly in the absence of symptomatology therefore prevention is important.

Checking and adjusting the upper cervical spine, when necessary, allows for a healthy flow of CSF and prevent the intracranial pressure.

What Are The Methods of CSF Flow

There are multiple ways for which CSF is allowed to flow up and down the spinal cord and brain such as:

  • Heart rate
  • Respiration
  • Movement (this is one reason why dementia and Alzheimer’s are more likely to develop in less active people later in life)
CSF Flow
Studies by Scott Rosa using an Upright MRI showing the change in CSF flow pre and post adjustment of the Upper Cx spine.

Trauma To The Upper Cervical Spine 

Research has also looked at the effect that trauma to the upper cervical spine, causing CSF stasis in the development of Multiple Sclerosis. Damadian et al (2011) noticed a pattern in people coming into chiropractic clinics with diagnosed MS who had prior injury to the neck. The study looked at 8 people without MS and 8 people with MS chosen on a “first come first served” basis. 7 of the MS patients had severe trauma to the head or neck, 5 of which were motor vehicle collisions. 

A Cine CSF flow study (video) which is an MRI over time showed leakages in the deep ventricles of the brain, areas responsible for CSF flow. CSF was seen to get blocked specifically in areas where there is damage/injury to the neck (Cervical spine) resulting in CSF stasis.


What the conclusion suggests is that stasis of the CSF causes a leakage of CSF which brings in 300 different polypeptides and at least 6 antigenic proteins which are not supposed to be in the brain causing an immune response to attack these substances and lead to an autoimmune response to the nerves demyelinating. Demyelination is therefore happening but there is a cause to it.

CSF Velocity Flow 

 This study included pre and post adjustment graphs of the CSF velocity flow. Post adjustment the velocity can be seen to stabilise meaning that it is flowing without interference and allowing for toxins to be removed and the appropriate nutrients to be delivered to the brain. Although the sample size is small for this study, it is important that more research in this area is carried out.

Contact Us 

If you have suffered from trauma to your head or neck, it is important to get you spine and nervous system checked to ensure that problems like these can be prevented. Please feel free to book in a complimentary 15 minute discovery call with one of the team to discuss your case and see if Upper Cervical Chiropractic care could be for you.


The Possible Role of Cranio-Cervical Trauma and Abnormal CSF Hydrodynamics in the Genesis of Multiple Sclerosis - Raymond V. Damadian and David Chu

Physiological Chemistry and Physics & Medical NMR 2011

Craniocervical Junction Syndrome: Anatomy of the Craniocervical and Atlantoaxial Junctions and the Effect of Misalignment on Cerebrospinal Fluid Flow - Scott Rosa, John W. Baird, David Harshfield and Mahan Chehrenama

November 6th 2017

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