Lymphatic drainage of the CNS: effects of lymphatic diversion/ligation on CSF protein transport to plasma.

The plasma recovery of an intraventricularly administered protein was compared before and after lymph diversion/ligation in the same conscious sheep to determine the relative roles of arachnoid villi and lymphatics in the clearance of a cerebral spinal fluid tracer. 125I-human serum albumin was injected into both lateral ventricles, and venous blood was sampled. One day later, multiple cervical vessels and the thoracic duct were cannulated for lymph collection. Uncannulated vessels were ligated. The experiment was repeated with 131I-human serum albumin as the tracer. Before lymph diversion/ligation, the time-averaged tracer transport into the plasma was 6.4 +/- 1.0%/h, with an average 6-h plasma recovery of 38.2 +/- 5.7% (percentage of injected dose). After lymph diversion/ligation, the values dropped to 2.9 +/- 0.5%/h and 17.7 +/- 2.7%, respectively. The collected lymph contained 8.7 +/- 2.6% of the tracer. No significant differences were observed in sham-operated animals. In conclusion, extracranial lymphatic vessels in sheep transport approximately one-half of the protein tracer from the cerebral spinal fluid compartment into plasma.