Paravascular spaces, entry or exit from the brain?

New Findings

What is the topic of this review?

In this symposium report we review the glymphatic clearance from the brain.

What advances does it highlight?

Evaluation of the evidence indicates that cerebrospinal fluid flows along paravascular spaces at the surface of the brain. However, bulk flow along penetrating arteries into the brain, followed by exit along veins, requires further confirmation. Clearance from the brain, based on mixing, may provide an alternative explanation for experimental findings.

Abstract

The interstitial fluid (ISF) of the brain provides the environment for proper neuronal function. Maintenance of volume and composition of ISF requires regulation of influx and removal of water, ions, nutritive and waste products. The recently described glymphatic pathway may contribute to some of these functions. It proposes that cerebrospinal fluid (CSF) enters the brain via paravascular spaces along arteries, mixes with ISF, and leaves the brain via paravascular spaces along veins. In this symposium report we review the glymphatic concept, its concerns, and alternative views on ISF‐CSF exchange.

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