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Articles in PresS, published online ahead of print June 27, 2002
Am J Physiol Regu Physiol, 10.1152/ajpregu.00173.2002
Submitted on March 18, 2002
Accepted on June 18, 2002
1 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Neuroscience Research, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario, Canada
* To whom correspondence should be addressed. E-mail: miles.johnston{at}swchsc.on.ca.
Arachnoid villi and granulations are thought to represent the primary sites where cerebrospinal fluid (CSF) is absorbed. However, these structures do not appear to exist in the fetus, but begin to develop around the time of birth and increase in number with age. Using a constant pressure perfusion system in 2-6 day old lambs, we observed that global CSF transport (0.012 ± 0.003 ml.min-1.cm H2O-1) and CSF outflow resistance (96.5 ± 17.8 cm H2O.ml-1.min) were very similar to comparable measures in adult animals despite the relative paucity of arachnoid villi at this stage of development. In the neonate, the recovery patterns of a radioactive protein CSF tracer in various lymph nodes and tissues indicated that CSF transport occurred through multiple lymphatic pathways. An especially important route was transport through the cribriform plate into extracranial lymphatics located in the nasal submucosa. To investigate the importance of the cribriform route in cranial CSF clearance, the cranial CSF compartment was isolated surgically from its spinal counterpart. When the cribriform plate was sealed extracranially under these conditions, CSF transport was impaired significantly. These data demonstrate an essential function for lymphatics in neonatal CSF transport and imply that arachnoid projections may play a limited role earlier in development.
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