Restoring Cerebrospinal Fluid Drainage Following Traumatic Brain Injury: Insights from Computational Modeling

Cerebrospinal fluid (CSF) envelops the brain and spinal cord, providing physical protection and essential nutrients. Recent studies have expanded our understanding of CSF's function, highlighting its role in removing metabolic wastes from the brain. This waste clearance includes drainage of CSF through multiple pathways, some of which empty into the cervical lymphatic vessels (CLVs) in the neck. We have recently showed that following traumatic brain injury (TBI), drainage through this pathway is severely impaired. We attributed this decrease in CLV drainage to impairment of CLV contractions (which drive fluid through CLVs), likely due to increased norepinephrine following TBI. To delve deeper into the relation of vessel contractility and CSF drainage, we use a lumped parameter model to simulate the CSF efflux from the brain to CLVs. Our objective is to gain insights into how altered contractility impacts CSF drainage. Additionally, we examine the evolutionary aspects of CSF drainage from the skull. Our results suggest the routes draining CSF to CLVs serve to dampen the oscillations in intracranial pressure. This analysis will provide avenues for investigating potential strategies to enhance CSF transport and for developing treatments for post-TBI conditions.