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Our current understanding of the lymphatics of the brain and spinal cord
Author(s) -
Dupont Graham,
Schmidt Cameron,
Yilmaz Emre,
Oskouian Rod J.,
Macchi Veronica,
de Caro Raffaele,
Tubbs R. Shane
Publication year - 2019
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.23308
Subject(s) - lymphatic system , glymphatic system , interstitial fluid , medicine , cerebrospinal fluid , spinal cord , lymph , anatomy , pathology , ventricular system , immune system , neuroscience , biology , immunology , psychiatry
The lymphatic system, segregated from the blood vascular system, is an essential anatomical route along which interstitial fluid, solutes, lipids, immune cells, and cellular debris, are conveyed. However, the way these mechanisms operate within the cranial compartment is mostly unknown. Herein, we review current understanding of the meningeal lymphatics, described anatomically over a century ago yet still poorly understood from a functional standpoint. We will delineate the cellular mechanisms by which the meningeal lymphatics are formed and discuss their unique anatomy. Furthermore, this review will discuss the recently‐coined “glymphatic system” and the manner by which cerebrospinal fluid (CSF) and interstitial fluid (ISF) are exchanged and thus drained by the meningeal lymphatic vasculature as a key route for conveying cellular waste, solutes, and immune traffic to the deep cervical lymph nodes. The clinical relevance of the meningeal lymphatics will also be described, as they are relevant to various common defects of the lymphatic system. Clin. Anat. 32:117–121, 2019. © 2018 Wiley Periodicals, Inc.