Introduction: Cerebrospinal fluid (CSF) circulates in the subarachnoid space around the brain and spinal cord, and in the ventricles of the brain. It serves as a buffer to protect the brain from physical and immunological damage. Since important actions such as removing soluble waste from the brain occur as the CSF circulates, various diseases including cognitive disorders can occur if CSF circulation is impaired. Therefore, it is very important to find anatomical treatment points that improve CSF circulation. Methods: We summarized various clinical symptoms and related diseases caused by CSF circulation failure and reviewed anatomical structures that could affect CSF circulation. Based on the reviewed data, we proposed several treatment points that can contribute to the improvement of CSF circulation. Results: Symptoms and diseases caused by decreased CSF circulation include headaches, sleep disorders, and Alzheimer's disease. In particular, Alzheimer's disease was also related to cerebral blood flow, which was also closely related to CSF circulation. The anatomical structure associated with CSF circulation was dura mater, deep cervical lymph nodes, meningeal lymphatic vessels, and emissary vein. The structures connected to the dura mater were also important, such as the myodural bridge (MDB) directly connected to the dura mater and the soft tissues such as the suboccipital muscles and ligaments connected to the dura mater via MDB.
Conclusion:We propose several treatment points based on anatomical structures that may affect CSF circulation. It is the soft tissues of the suboccipital site including MDB, submucosal tissue of the nasal cavity, stylomastoid foramen, and emissary vein.