Lymphatic drainage of the cerebrospinal fluid from monkey spinal meninges with special reference to the distribution of the epidural lymphatics.

The structural organization of the epidural lymphatics and lymphatic drainage of the cerebrospinal fluid from spinal meninges was studied in Japanese monkeys (Macaca fuscata) by an enzyme-histochemical method. The spinal meninges were examined at various intervals from 1 to 48 h, as well as at 30 days, following an injection of ultrafine carbon particles into the subarachnoidal space (cisterna magna). Lymphatics were differentiated from blood capillaries by the 5'-nucleotidase (5'-Nase)-alkaline phosphatase (ALPase) double staining method (KATO et al. 1991, 1993) both in the whole-mount preparations and tissue sections. Carbon-filled collecting lymphatics and lymph nodes constantly appeared in the cervical and thoracic regions but only rarely in the lumbo-sacral region after carbon injection. Networks of 5'-Nase-positive lymphatics in the epidural connective tissues were seen in a large area on the dorsal surface around each spinal nerve root in the cervical and upper thoracic regions, especially at a level corresponding to the brachial plexus (C5-Th1). Carbon particles were often found within the 5'-Nase-positive lymphatics. In the lower thoracic and lumbo-sacral regions, on the other hand, the epidural lymphatic network covered only a small area around each spinal nerve root. These findings suggest that the epidural lymphatics are well developed on the dorsal side of the lower cervical spinal dura mater and may function as an absorptive pathway for the cerebrospinal fluid from the subarachnoidal space.