Beschreibung:
<jats:sec><jats:title /><jats:p>Brain interstitial fluid (ISF) drainage plays an important role in neurological disease. A complete picture of ISF drainage pathways is still being pieced together. Most current data are from animals not humans. ISF may enter the cerebrospinal fluid (CSF), which then leaves via arachnoid granulations, dural lymphatics, the cribriform plate, and cranial and spinal nerve root sleeves. CSF-independent routes of ISF drainage are less clear, and include the peri-arterial pathway, a controversial peri-venous route, and possibly brain- to-blood efflux across capillary endothelium. We present an exploratory study of the cranial nerve ISF outflow in humans, using high-resolution magnetic resonance imaging pre- and post- administration of gadolinium-based contrast agent, in a healthy volunteer and in a person with a large enhancing multiple sclerosis (MS) brainstem lesion. We reasoned that the high contrast concentration in the restricted interstitial space of the lesioned brainstem would highlight drainage pathways. While cranial nerve enhancement was present in both cases, it was most marked in the MS case. Through analysis of the spatial and temporal kinetics of enhancement we explore ISF drainage along cranial nerves and its dependence on transfer to CSF. These findings have implications for our understanding of brain ISF movement in health and disease.</jats:p><jats:p>a.varatharaj@soton.ac.uk</jats:p></jats:sec>