Johnston Miles
Neuroscience Research, Department of Laboratory Medicine and Pathobiology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Lymphat Res Biol. 2003;1(1):41-4; discussion 45. doi: 10.1089/15396850360495682.
Despite the fact that the central nervous system parenchyma does not contain lymphatics, extracranial lymphatic vessels play a very important role in volumetric cerebrospinal fluid (CSF) transport. The most important extracranial location at which lymphatics gain access to CSF is in the nasal submucosa after CSF convects through the cribriform plate. At relatively low intracranial pressures (ICPs), the majority of cranial CSF absorption occurs through this pathway. Global CSF transport parameters in the late gestation fetus and adult sheep are very similar, even though significant numbers of arachnoid projections seem to exist only in the adult. Therefore, extracranial lymphatic vessels play an important role in CSF transport before birth and may represent the primary mechanism for CSF absorption in the neonate. Based on these considerations, hydrocephalus may involve reduced CSF transport to, or into extracranial lymphatic absorption sites.
尽管中枢神经系统实质中不含有淋巴管，但颅外淋巴管在脑脊液（CSF）的容量运输中发挥着非常重要的作用。淋巴管进入脑脊液的最重要颅外部位是在脑脊液通过筛板对流后进入鼻黏膜下层。在相对较低的颅内压（ICP）下，大部分颅腔脑脊液的吸收通过该途径发生。妊娠晚期胎儿和成年绵羊的整体脑脊液运输参数非常相似，尽管大量蛛网膜突起似乎仅存在于成年个体中。因此，颅外淋巴管在出生前的脑脊液运输中发挥重要作用，并且可能是新生儿脑脊液吸收的主要机制。基于这些考虑，脑积水可能涉及脑脊液向颅外淋巴吸收部位的运输减少或进入这些部位的过程受阻。
