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Exchange of solutes between the CSF and the ISF is driven by arterial pulsation and regulated during sleep by the expansion and contraction of brain extracellular space. The name “glymphatic system” was coined by the Danish neuroscientist Maiken Nedergaard in recognition of its dependence upon glial cells and the similarity of its functions to those of the peripheral lymphatic system. While glymphatic flow was initially believed to be the complete answer to the long-standing question of how the sensitive neural tissue of the CNS functions in the perceived absence of a lymphatic drainage pathway for extracellular proteins, excess fluid, and metabolic waste products, two subsequent articles by Louveau et al.
University of Virginia School of Medicine and Aspelund et al. University of Helsinki reported independently the discovery that the dural sinuses and meningeal arteries are in fact lined with conventional lymphatic vessels, and that this long-elusive vasculature forms a connecting pathway to the glymphatic system. CSF during his search for the seat of the soul. The 16 centuries of anatomists that came after Hippocrates and Galen may have missed identifying the CSF due to the time period’s prevailing autopsy technique, which included severing the head and draining the blood before dissecting the brain.
1887 due to his lack of medical credentials, he may have also made the first connection between the CSF and the lymphatic system. His description of the CSF was of a “spirituous lymph”.
In the peripheral organs, the lymphatic system performs important immune functions, and runs parallel to the blood circulatory system to provide a secondary circulation that transports excess interstitial fluid, proteins and metabolic waste products from the systemic tissues back into the blood. The efficient removal of soluble proteins from the interstitial fluid is critical to the regulation of both colloidal osmotic pressure and homeostatic regulation of the body’s fluid volume.
The importance of lymphatic flow is especially evident when the lymphatic system becomes obstructed. The resulting chronic edema is due to the breakdown of lymphatic clearance and the accumulation of interstitial solutes.
In 2015, the presence of a meningeal lymphatic system was first identified by two independent studies by Louveau et al. CNS, could replace peripheral lymphatic functions and play an important role in the clearance of extracellular solutes.