New Discovery Makes Researchers Rethink CSF Absorption

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lymphatic vessels in the brainThe discovery of lymphatic vessels in the brain overturns decades of scientific dogma and provides a new target for scientific investigation. For hydrocephalus researchers, this discovery is extremely exciting because the lymphatic system represents an alternative route for cerebrospinal fluid (CSF) absorption.

The lymphatic system is a network of vessels, tissues, and organs that serves two key roles in the body. The lymphatic system plays a major role in fighting disease, producing white blood cells to fight inflammation or to fight a toxic or foreign substance. Has a doctor ever told you your lymph nodes are swollen? They are reacting to an infection or illness, trapping and destroying bacteria, viruses, and other harmful substances.

The lymphatic system is also responsible for maintaining fluid balance by draining excess fluid, called lymph, into the bloodstream. In doing so, the lymphatic system helps maintain appropriate fluid volumes and clears waste products from tissue.

Previously, it was believed that the lymphatic system did not exist in the brain. One of the few known connections was through the cribriform plate. The cribriform plate is located at the junction of the nose and forehead. It is perforated, allowing direct connections between CSF and the lymphatic system. Past Hydrocephalus Association grantee, Miles Johnston, PhD, tested drugs administered via a nasal mist to modulate the absorption of CSF through this pathway. In his proof of concept paper, the nasal mist increased CSF absorption at elevated intracranial pressures.

Two new studies from Aspelund and colleagues, and Louveau and colleagues show that lymphatic vessels are in fact present in the brain. In addition, both studies show that these vessels are actively involved in CSF clearance. What we do not yet know is if these lymphatic vessels are a major player in CSF absorption, are involved in the development of hydrocephalus, or if they can be modulated to help improve CSF absorption and decrease intracranial pressure. The potential to increase fluid uptake into these vessels provides a new target for hydrocephalus researchers searching for non-invasive ways to increase CSF absorption.

8 Comments for : New Discovery Makes Researchers Rethink CSF Absorption
    • Teresa Jones
    • October 15, 2020

    My husband has increased icp and they are talking about doing a bp shunt. We do not want to try that b/c he has bilateral dbs for Parkinson Disease and we do not want to chance an infection. I am interested in this information

    • Davina E. Acevedo
    • August 11, 2019

    I’m happy there is great hope for the ones who truly don’t want to have a shunt implant!!!

    Is there a cure for both hydrocephalus and lymphedema?

    • Leah
    • April 30, 2019

    Is there any current research connecting swollen lymph nodes to Chiari Malformation 1 and/or syrinx?

    • Michelle
    • March 22, 2018

    HELP! I have a VP shunt placed as a result of intracranial hypertension along with Chiari malformation. I also have Ehlers Danlos and am currently going through treatment for full body Progressive lippo lymphedema and it is putting so much pressure on my VP shunt I am going to need to stop therapy! My neurosurgeon is Robert Friedlander out of UPMC Pittsburgh Presbyterian Hospital I’m open to any research or suggestions you may have

    • ian sawdon
    • February 1, 2018

    Hi, my 47 year old brother is currently in hospital after many shunt replacement operations in the space of 3 years (approx. 30 ops at this stage) He keeps getting infections and the latest shunt managed to work its way out of his skull. (Too much scar tissue I suppose).
    Would he be a candidate for this approach?

    • nasreen
    • November 9, 2016

    Realy is it possible i just want this forign body to get out of my son’s body shung is a all time horifier plz i request to neurologists to search an alternate n permanent source of csf removal procedure which will b perform in patients body only once in his life Often Shunt replacment is very expensive i m very hardly affording it n hv sold out my everything n is soooo painful too

    • Bestriz Tasior
    • September 17, 2016

    Hi, when will they develop this nasal spray?

    • Philip J. Mastromonico
    • May 12, 2016

    I would be wary of lymphatic system drainage. The lymph nodes are SO necessary and yet SO susceptible. My mother died of a lymph node bursting in her brain after a 2 year fight with stage 4 melanoma. Wouldn’t drainage of CSF into the lymphatic system alter the beneficial characteristics of lymph itself?

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