Cerebrospinal fluid leakage after posterior fossa surgery may impair brain metabolite clearance

Neurochirurgie. 2018 Dec;64(6):422-424. doi: 10.1016/j.neuchi.2018.08.003. Epub 2018 Oct 24.


The discovery of the important role of cerebrospinal fluid (CSF) drainage of cerebral metabolite waste, known as the glymphatic system, has changed our view of brain waste clearance. We recently performed experiments to evaluate the glymphatic system in non-human primates (NHP). Here, we report the case of an NHP with iatrogenic CSF leakage. In this animal, solute transport through the brain, assessed by gadolinium injection in the CSF, was severely impaired by iatrogenic pseudomeningocele. This observation raises an important question: does brain surgery, and particularly posterior fossa surgery, lead to chronic impairment of parenchymal CSF circulation and solute transport?

Keywords: Cerebrospinal fluid; Glymphatic system; Neurosurgery; Non-human primate.

MeSH terms

  • Animals
  • Brain / metabolism
  • Brain / surgery*
  • Cerebrospinal Fluid / drug effects*
  • Cerebrospinal Fluid Rhinorrhea / etiology*
  • Cerebrospinal Fluid Rhinorrhea / surgery
  • Gadolinium / therapeutic use
  • Glymphatic System / surgery*
  • Humans
  • Primates


  • Gadolinium