Does Impaired Glymphatic Drainage Cause Glymphedema? A Review Tailored to Neurocritical Care and Neurosurgery—Akins 2021

The glymphatic system was recognized and named in 2012, but its roots go back to Cushing, Weed, and Dandy. The glymphatic system enhances bulk fluid and solute movement throughout the brain parenchyma. We address CNS lymphatic drainage. Neurocritical care and neurosurgery professionals increasingly believe that glymphatic system failure causes glymphedema. We examine research on decompressive craniectomy, subarachnoid hemorrhage, and normal-pressure hydrocephalus. We believe that the standard model of cerebrospinal fluid circulation should be altered to include the glymphatic pathway and lymphatic clearance. These insights will inspire novel therapeutic techniques to recognize, reverse, and restore glymphatic dysfunction and to deliver brain-wide treatments.

Akins, P. T., & Guppy, K. H. (2021). Does Impaired Glymphatic Drainage Cause Glymphedema? A Review Tailored to Neurocritical Care and Neurosurgery. Neurocritical care, 35(2), 545–558. https://doi.org/10.1007/s12028-021-01224-1