The River Round the Room
Asystole

Morning gathers at the window,
We draw one river on the page.

Choroid plexus makes most of the fluid,
In the ventricles tucked inside.
Two lateral chambers start our tracing,
Monro's openings, left and right.
Through the third, then the aqueduct,
Down to the fourth, we follow slow.
Magendie, Luschka, open outward,
To the space where the fluid flows.

Lateral, Monro, third,
Aqueduct, fourth, remember the words.
Magendie, Luschka, out we go,
Subarachnoid space below.
Round the brain and down the spine,
Follow the fluid one more time.
Villi to veins, one way to drain,
The river circles round again.

Dura on the outside, tough,
Arachnoid underneath that cover.
Pia hugs the brain and cord,
Three soft names to put in order.
Between arachnoid and the pia,
Fluid cushions brain and spine.
Arachnoid villi lead toward veins;
Other outflow routes help fluid drain.

Lateral, Monro, third,
Aqueduct, fourth, remember the words.
Magendie, Luschka, out we go,
Subarachnoid space below.
Round the brain and down the spine,
Follow the fluid one more time.
Villi to veins, one way to drain,
The river circles round again.

Block the passage, upstream chambers
Can grow larger as fluid stays.
Communicating: paths stay open,
Yet absorption can be delayed.
Blood or meningitis can disturb
The ways the fluid drains away.
Normal-pressure hydrocephalus:
Gait, thinking, bladder may all change.
Pressure may read in normal range;
The scan and whole story help explain.
Three clues start an investigation,
Every person needs their own.

Lateral, Monro, third,
Aqueduct, fourth, remember the words.
Magendie, Luschka, out we go,
Subarachnoid space below.
Round the brain and down the spine,
Follow the fluid one more time.
Villi to veins, one way to drain,
The river circles round again.

The light is warm; the notes are closed,
We leave a little room for what we'll know.