兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.     

Olfactory route for cerebrospinal fluid drainage into the cervical lymphatic system in a rabbit experimental model

The present study analyzed the anatomical association between intracranial subarachnoid space and the cervical lymphatic system. X-ray contrast medium and Microfil (Microfil compounds fill and opacify microvascular and other spaces of non-surviving animals and post-mortem tissue under physiological injection pressure) were injected into the cisterna magna of the rabbit, and perineural routes of cerebrospinal fluid outflow into the lymphatic system were visualized. Under a surgical operating microscope, Microfil was found within the subarachnoid space and along the olfactory nerves. At the nasal mucosa, a lymphatic network was identified near the olfactory nerves, which crossed the nasopharyngeal region and finally emptied into the superficial and deep cervical lymph nodes. Under a light microscope, Microfil was visible around the olfactory nerves and within lymphatic vessels. These results suggested that cerebrospinal fluid drained from the subarachnoid space along the olfactory nerves to nasal lymphatic vessels, which in turn, emptied into the cervical lymph nodes. This anatomical route, therefore, allowed connection between the central nervous system and the lymphatic system.     

CSF drains directly from the subarachnoid space into nasal lymphatics in the rat. Anatomy, histology and immunological significance

Cerebrospinal fluid (CSF) drainage pathways from the rat brain were investigated by the injection of 50 μl Indian ink into the cisterna magna. The distribution of the ink, as it escaped from the cranial CSF space, was documented in 2 mm thick slices of brain and skull cleared in cedar wood oil and in decalcified paraffin sections. Following injection of the ink, deep cervical lymph nodes were selectively blackened within 30 min and lumbar para-aortic nodes within 6 h. Within the cranial cavity, carbon particles accumulated in the basal cisterns but were also distributed in the paravascular spaces around the middle cerebral arteries and the nasal-olfactory artery. Carbon particles in the subarachnoid space beneath the olfactory bulbs drained directly into discrete channels which passed through the cribriform plate and into lymphatics in the nasal submucosa. Although ink was distributed along the subarachnoid space of the optic nerves and entered the cochlea, the nasal route was the only direct connection between cranial CSF and lymphatics. Arachnoid villi associated with superior and inferior sagittal sinuses were identified and a minor amount of drainage of ink into dural lymphatics was also observed. This study demonstrates the direct drainage of cerebrospinal fluid through the cribriform plate in anatomically defined channels which connect with the nasal lymphatics. Such a pathway is compatible with the observed rapidity of the bulk flow drainage of CSF in the rat, accords with the known specificity of immunological reactions to antigens injected into brain tissue, and may also serve as a route for drainage for lymphocytes and macrophages from the brain to the regional cervical lymph nodes.     

Lymphatic cerebrospinal fluid absorption pathways in neonatal sheep revealed by subarachnoid injection of Microfil

There is mounting evidence that a significant portion of cerebrospinal fluid drainage is associated with transport along cranial and spinal nerves with absorption taking place into lymphatic vessels external to the central nervous system. To characterize these pathways further, yellow Microfil^® was infused into the cisterna magna of 2–7-day-old lambs post mortem to perfuse either the cranial or spinal subarachnoid compartments. In some animals, blue Microfil was perfused into the carotid arteries simultaneously. Microfil was observed in lymphatic networks in the nasal mucosa, covering the hard and soft palate, conchae, nasal septum, the ethmoid labyrinth and the lateral walls of the nasal cavity. Many of these lymphatics drained into vessels located on the lateroposterior wall of the nasopharynx and from this location drained to the retropharyngeal lymph nodes. Additionally, lymphatics containing Microfil penetrated the lateral wall of the nasal cavity and joined with superficial lymphatic ducts travelling towards the submandibular and preauricular lymph nodes. In two cases, lymphatic vessels were observed anastomosing with deep veins in the retropharyngeal area. Microfil was also distributed within the nerve trunks of cranial and spinal nerves. The contrast agent was located in longitudinal channels within the endoneurial space and lymphatics containing Microfil were observed emerging from the mesoneurium. In summary, Microfil distribution patterns in neonatal lambs illustrated the important role that cranial and spinal nerves play in linking the subarachnoid compartment with extracranial lymphatics.     

一种新的显示蛛网膜下腔与颈部淋巴管交通的研究方法：Microfil^TM蛛网膜下腔注射

目的采用一种新的方法在形态学上证实兔和大鼠蛛网膜下腔与颈部淋巴系统相通。方法在刚死亡的兔和大鼠枕大池内注射Microfil^TM,注射2h后在手术显微镜下观察灌注物质在蛛网膜下腔及头颈部淋巴管内的分布。结果Microfil^TM在兔和大鼠枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色而呈黄色,经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管。两种动物的Microfil^TM染色范围没有明显差别。结论Microfil^TM蛛网膜下腔注射是显示蛛网膜下腔与颈部淋巴系统相通的一种有效且便捷的方法。     

The nasal route of cerebrospinal fluid drainage in man. A light–microscope study

The drainage routes from the subarachnoid space to the nasal mucosa were investigated in autopsy material. Indian ink, applied post–mortem to the olfactory groove, promptly filled the perineurial spaces around the olfactory nerve branches in the dura, the lamina cribrosa and the submucosal tissue in the nose. In a case of recent subarachnoid haemorrhage, the perineurial spaces even around the most distal olfactory nerve branches were congested with blood and there was an abundant accumulation of red corpuscles in the apical part of the nasal mucosa. Iron–containing pigment was found in the perineurial spaces of proximal and distal olfactory nerve branches as well as in the nasal mucosal stroma in cases with older haemorrhagic lesions. The findings show that the perineurial spaces provide an efficient drainage route from the subarachnoid space to the nasal mucosa in cases with haemorrhagic cerebral lesions. A complementary drainage route for the cerebrospinal fluid was indicated by the presence of indian ink, red corpuscles and iron pigment in arachnoid villi, which penetrated the lamina cribrosa and ended in the nasal submucosal tissue. Iron in the deep cervical lymph nodes should not be taken as evidence of transport from the CNS, since iron pigment was also found in cases without intracranial haemorrhage.     

Dynamic properties of lymphatic pathways for the absorption of cerebrospinal fluid

To study the dynamics of the outflow of cerebrospinal fluid (CSF) into the cervical lymphatic system, X-ray contrast medium or Indian ink was infused into the cisterna magna of rats at moderately increased intracranial pressure (40–50 mm Hg). In the first series of experiments, while the contrast medium was being infused, the animal’s head was examined using X-ray-microscopy (× 4–20 direct magnification radiography) and conventional radiography. Within the first minutes of infusion, the flow of CSF was directed from the posterior fossa to the olfactory bulb. Reaching the cribriform plate approximately 7 min after starting the infusion, the contrast medium leaked into the nasal cavities. Some minutes later, it opacified the subarachnoid space (SAS) of the optic nerve, the perilymphatic space of the inner ear, the cortical SAS, and the transverse sinuses. Leakage from the optic nerve SAS into the orbit was seen after 30 min infusion. In the second series of experiments, the Indian ink was infused after microsurgical exposure of the cervical lymph vessels. During the infusion the cervical lymph ducts were observed microscopically (× 40 magnification). Single dye particles draining through the cervical lymph ducts appeared 20 min after the start of cisternal infusion. Their transport was rapid, and dependent on the respiratory cycle: during inspiration the particles moved at a speed of 10–20 mm/s, during expiration the movement stopped. Thus, rapid kinetics are demonstrated for the outflow of CSF and particles from the SAS into the cervical lymphatics. Received: 11 February 1997 / Revised, accepted: 14 April 1997     

Directional and compartmentalised drainage of interstitial fluid and cerebrospinal fluid from the rat brain

Summary Pathways for drainage of interstitial fluid and cerebrospinal fluid from the rat brain were investigated by the injection of 2–5 l Indian ink into cerebral white and grey matter and into the subarachnoid space over the vertex of the left frontal lobe. Animals were killed by formalin or glutaraldehyde perfusion 5 min-2 years after injection, and the distribution of ink over the surface of the brain, in 2-mm slices of brain cleared in cedar wood oil, in paraffin sections and by electron microscopy was documented. These investigations showed that carbon particles were distributed diffusely through the interstitial spaces of the white matter whereas they spread selectively along perivascular spaces in the grey matter outlining both arteries and veins and extending to surround capillaries within 1 h. Carbon particles were rapidly ingested by perivascular cells and, to some extent, by meningeal cells surrounding the larger vessels. Very little movement of carbon-labelled perivascular cells and perivascular macrophages was seen after 2 years. Carbon particles entering the subarachnoid space over the vertex of the cerebral hemispheres drained along selected paravascular and subfrontal pathways in the subarachnoid space to the cribriform plate and thence into nasal lymphatics and cervical lymph nodes. These studies demonstrate the diffuse spread of fluidborne tracers through cerebral white matter in the rat, the perivascular spread of tracer in grey matter and the compartmentalised directional flow or tracer through the subarachnoid space to the cribriform plate and nasal lymphatics. Furthermore, particulate matter selectively injected into perivascular spaces in rat grey matter is rapidly and efficiently ingested by perivascular cells.E. T. Z. supported by the James Gibson Fund, the Wessex Medical Trust, the Wessex Neurological Centre Research Trust, and the Sino-British Society     

Subarachnoid injection of Microfil reveals connections between cerebrospinal fluid and nasal lymphatics in the non-human primate

Based on quantitative and qualitative studies in a variety of mammalian species, it would appear that a significant portion of cerebrospinal fluid (CSF) drainage is associated with transport along cranial and spinal nerves with absorption taking place into lymphatic vessels external to the central nervous system. CSF appears to convect primarily through the cribriform plate into lymphatics associated with the submucosa of the olfactory and respiratory epithelium. However, the significance of this pathway for CSF absorption in primates has never been established unequivocally. In past studies, we infused Microfil into the subarachnoid compartment of numerous species to visualize CSF transport pathways. The success of this method encouraged us to use a similar approach in the non-human primate. Yellow Microfil was injected post mortem into the cisterna magna of 6 years old Barbados green monkeys (Cercopithecus aethiops sabeus, n = 6). Macroscopic and microscopic examination revealed that Microfil was (1) distributed throughout the subarachnoid compartment, (2) located in the perineurial spaces associated with the fila olfactoria, (3) present within the olfactory submucosa, and (4) situated within an extensive network of lymphatic vessels in the nasal submucosa, nasal septum and turbinate tissues. We conclude that the Microfil distribution patterns in the monkey were very similar to those observed in many other species suggesting that significant nasal lymphatic uptake of CSF occurs in the non-human primate.     

兔脑脊液颈淋巴回流的X-线造影检查

目的研究兔蛛网膜下腔与颈部淋巴系统是否交通。方法对10只新西兰大白兔分别行脑脊液颈淋巴回流及颈淋巴管X-线造影检查。结果脑脊液颈淋巴回流造影显示造影剂在注射后7min到达筛板，20min到达视神经远端，30min后从鼻腔漏出，同时颈部淋巴管显影。颈淋巴管造影检查显示注射初期造影剂在枕大孔周围流动缓慢，经视神经近端缓慢流动至视交叉；继之鼻中隔、筛板、内耳道、上矢状窦附近淋巴管及颈浅淋巴管显影。结论蛛网膜下腔与颈部淋巴系统之间相交通，在一定压力下，颈部淋巴管内淋巴液可逆行流入颅内：这一现象的病理生理学意义尚待进一步研究。