Our traditional understanding of CSF circulation is that it is produced by the choroid plexus and circulates through the ventricles and subarachnoid spaces, exiting directly into the dural venous sinuses via arachnoid granulations/villi ( 1– 5). The critical involvement of cerebrospinal fluid (CSF) in metabolic cerebral waste clearance (CWC) has gained a lot of momentum lately. These findings suggest that anatomically, substance exchange between the brain parenchyma and outside tissues including lymphatic ones can only occur through CSF pathways and/or vascular pathways, warranting further investigation into its implications in cerebral waste clearance and immunity. In other words, all peri-neural spaces surrounding the cranial and spinal nerves as well as all peri-vascular spaces surrounding MRI-visible vasculature were filled with CSF. Our findings indicated that all CNS neuro- and vascular-communication channels are surrounded with CSF. Four MRI protocols each with five participants were used to image the CSF in the brain and spinal cord. Therefore, the objective of this study was to use magnetic resonance imaging (MRI) to simultaneously map the presence of CSF within all peri-neural (cranial and spinal nerves) and peri-vascular spaces in vivo in humans. It is already very well-established that the central nervous system (CNS) is completely submerged in CSF on a macro-level but to what extent is this true on a micro-level? Specifically, within the peri-neural and peri-vascular spaces within the CNS parenchyma. 4Department of Neurology, Henry Ford Health System, Detroit, MI, United Statesīackground: Recent emerging evidence has highlighted the potential critical role of cerebrospinal fluid (CSF) in cerebral waste clearance and immunomodulation.3Department of Radiology, Wayne State University, Detroit, MI, United States.2Department of Neurology, Wayne State University, Detroit, MI, United States.1Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States.
Mark Haacke 3, Jiani Hu 3 * and Quan Jiang 4 *
Fahmy 1 †, Yongsheng Chen 2 †, Stephanie Xuan 3, E.
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