Drainage of CSF through lymphatic pathways and arachnoid villi in sheep: measurement of 125I-albumin clearance.

We investigated lymphatic drainage pathways of the central nervous system in conscious sheep and quantified the clearance of a cerebrospinal fluid (CSF) tracer into lymph and blood. In the first group of studies, 125 I-HSA was injected into the lateral ventricles of the brain or into lumbar CSF and after 6 h, various lymph nodes and tissues were excised and counted for radioactivity. Multiple lymphatic drainage pathways of cranial CSF existed in the head and neck region defined by elevated 125 I-HSA in the retropharyngeal/cervical, thymic, pre-auricular and submandibular nodes. Implicated in spinal CSF drainage were mainly the lumbar and intercostal nodes. In a second group of experiments, multiple cervical vessels and the thoracic duct were cannulated and lymph diverted from the animals. Transport of tracer through arachnoid villi was taken from recoveries in venous blood. Following intraventricular administration, the 6 h recoveries of 125 I-HSA in the lymph (sum of cervical and thoracic duct) and blood were 8.2% ± 3.0 and 12.5% ± 4.5 respectively and at 22 h, 25.1% ± 6.9 and 20.8% ± 4.1 respectively. When 125 I-HSA was injected into lumbar CSF, the 6 h recoveries of tracer in thoracic duct and blood were 11.6% ± 2.7 and 16.3% ± 3.7 respectively. Total lymph and blood recoveries were not significantly different in any experiment. We conclude that the clearance of 125 I-HSA from the CSF is almost equally distributed between lymphatic and arachnoid villi pathways.