PMC:6194691 / 24096-26033
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6194691","sourcedb":"PMC","sourceid":"6194691","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6194691","text":"There has been controversy about the nature of the connections between the perivascular spaces adjacent to larger blood vessels within the parenchyma, the CSF and the perivascular spaces of the vessels passing through the subarachnoid spaces [1, 16, 25, 54, 71, 72, 81, 103–109]. However, whatever the exact perivascular pathway used, solutes exiting from the parenchyma along perivascular routes appear to be effluxed partly to CSF in the basal cisterns or subarachnoid spaces and partly to the outer meninges [85] and/or lymphatics [94, 107, 109–115]. Movement of small solutes and water does take place between fluid in the subarachnoid space and fluid within the perivascular spaces (see Section 4.1.1.1 of [41]). However a substantial proportion of perivascular efflux of large solutes appears to pass to lymph without first appearing in CSF in the cisterna magna6 (see Fig. 6) [16, 39, 52, 82, 83, 94, 96, 105, 107, 111, 115–119].\nFig. 6 Schematic diagram indicating possible routes for efflux of large solutes from the parenchyma along perivascular routes. a Large solutes emerging from the parenchyma via intramural or extramural routes along arteries (and possibly veins) may either mix with CSF or continue along the walls of blood vessels. The blood vessels span the subarachnoid space (see Figs. 1 and 6) before leaving the brain to reach the rest of the body. The fluid that continues along these vessels may enter either blood or lymph, but solutes as large as serum albumin will enter only lymph. b Large solutes that have reached CSF will be taken to sites of CSF outflow including the arachnoid villi, where the solutes will enter venous blood, and the cribriform plate, where they will enter lymph. (Based primarily on data for radio-iodinated serum albumin RISA [82, 83, 125] and on the location of the pia surrounding arteries taken from [103]). The anatomical relations of the pathways or spaces remain 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