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. Author manuscript; available in PMC: 2024 Feb 16.
Published in final edited form as: J Magn Reson Imaging. 2023 May 4;59(2):431–449. doi: 10.1002/jmri.28759

FIGURE 1:

FIGURE 1:

Schematic drawing on a coronal section of the brain illustrating the interaction between neurofluid compartments and BP with possible neurological diseases (white text inserts) that can be a result of their derangement: Leptomeningeal arteries and penetrating arterioles branch out from the carotid arteries (CA) and form a dense network on the surface of the pia in the cerebral subarachnoid space (CSAS). The CSF is (a) produced from the CP, flows (b) caudally into the aqueduct of Sylvius (AoS) toward the CSAS via the foramen of Luschka and Magendie (LML) and into the spinal subarachnoid space (SSAS), (c) may exit via the ventricular ependymal wall toward the BP and also (d) CSF drains into the dural venous sinus through Ag. (e) CSF can recirculate into the BP via arterial perivascular space (APS) and into the BP through AQP-4 water channels. Bulk flow and/or diffusion processes move ISF/CSF from the BP toward the venous perivascular space (VPS), transporting metabolic waste out toward the CSAS and into the dural venous sinus. IPAD pathway is the flow of ISF in the opposite direction to arterial flow along the BM of arteries (zoomed box) and leaves the intracranial cavity along the walls of the CA into the deep cervical lymph nodes. Both extrinsic and intrinsic innervations line the arterial and capillary walls respectively, and are determinants of cerebral autoregulation. The venous system is represented on the surface of the CSAS. Cortical veins drain into the superficial venous sinus system (dural venous sinus). Venous blood exits out of the intracranial cavity toward the heart via internal jugular veins (IJV) and vertebral veins (not shown). Meningeal lymphatics are channels that line the dural venous sinus, the cranial nerve sheaths, the cribriform plate and also the basal venous plexi, draining CSF via perineural sheaths. BP is made up of 80%–85% of cells and ISF. CADASIL = cerebral autosomal dominant arterial with subcortical infarcts and leukoencephalopathy. CAA = cerebral amyloid angiopathy. (adapted from Agarwal et al1).