Fig. 21 Putative routes for periarterial efflux. In the intramural proposal solutes move parallel to the vessel wall along the basement membranes of the smooth muscle layer, shown as blue trajectories. In the extramural proposal movements of solutes parallel to the vessel occur primarily in a perivascular space with lower resistance to flow. They also move in and out of the wall by a combination of diffusion and convection, shown as the red trajectories. As discussed in Sect. 3.1 the nature of the extramural pathway is still controversial including whether it is a space one side or the other of the pial cells or alternatively the pial and glial basement membranes themselves. endo endothelium, s.m smooth muscle, BM basement membrane. Pial cells and pial basement membrane(s) are shown together because they are very thin