This observational analysis identifies clearance pathways in cerebral infarction using contrast MRI, suggesting novel insights into meningeal lymphatic vessels.
Motivation: To observe clearance pathways in patients with cerebral infarction. Goal(s): The goal of this study is to identify novel in vivo human findings regarding the clearance pathways in patients with cerebral infarction. Approach: 3D T1 DANTE SPACE imaging was performed 1-5 hours after intravenous injection of gadolinium-based contrast agent (GBCA). Results: All 4 large infarction (>5cm) cases in 10 patients had delayed enhancement of the neighboring dura matter. Almost all cases had delayed enhancement of white matter much broader than the infarct sites. Delayed enhancement of cranial nerves and dural sinuses were independent of the affected side. Impact: Delayed enhancement of neighboring dura mater, pia mater, and CSF space was observed in the large infarction. We believe our study uncovered the pathway immediately upstream of the meningeal lymphatic vessels surrounding venous sinuses and cranial nerves, as previously reported.
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Umehana et al. (2025) studied this question.
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