Meningeal lymphatic architecture and drainage dynamics surrounding the human middle meningeal artery
The anatomical basis of cerebrospinal and interstitial fluid clearance along the human ventral meninges remains poorly defined. Here, we present the <i>in vivo</i> and <i>ex vivo</i> evidence of a distinct CSF-ISF drainage compartment surrounding the middle meningeal artery (MMA) in humans. In five healthy participants, dynamic contrast-enhanced MRI revealed delayed signal enhancement along the MMA-peripheral region, peaking at 90 min, substantially later than adjacent vascular and lymphatic structures, consistent with slower, nonvascular clearance dynamics. To validate these findings, we performed the high-resolution spatial mapping of the dorsal and ventral dura using immunofluorescence and imaging mass cytometry, identifying PROX1+, PDPN+, and LYVE1+ lymphatic-like structures that are aligned along the MMA. These findings define a previously unrecognized outflow zone in the human ventral dura and support the presence of organized meningeal lymphatic architecture beyond dorsal compartments. This integrated human framework motivates future mechanistic studies into the role of ventral lymphatics in brain fluid clearance and neuroimmune regulation.
Authors
- Önder Albayram (ORCID: https://orcid.org/0000-0002-2028-1458)
- Hiranmayi Ravichandran (ORCID: https://orcid.org/0000-0001-8671-7667)
- Yashar Kalani
- Filiz Bunyak (ORCID: https://orcid.org/0000-0002-0421-6920)
- Rachael D. Seidler (ORCID: https://orcid.org/0000-0003-2452-9024)
- Sutton B. Richmond (ORCID: https://orcid.org/0000-0003-0205-7492)
- Kaan Yağmurlu (ORCID: https://orcid.org/0000-0002-7635-2809)
- İbrahim Sacit Tuna (ORCID: https://orcid.org/0000-0003-4170-6483)
- Sait Albayram (ORCID: https://orcid.org/0000-0001-9111-6815)
- Fatih Tufan (ORCID: https://orcid.org/0000-0003-3245-1618)
- Adviye Ergul (ORCID: https://orcid.org/0000-0003-0873-6015)
- Eda Karakaya (ORCID: https://orcid.org/0000-0003-4156-3785)
- Melike Mut (ORCID: https://orcid.org/0000-0002-9601-9907)
- Emal Lesha (ORCID: https://orcid.org/0000-0002-8902-3537)
Institutions
- Medical University of South Carolina (US)
- University of Tennessee Health Science Center (US)
- Cornell University (US)
- AdventHealth Orlando (US)
- Lander Institute (IL)
- University of Florida (US)
- St. John Medical Center (US)
- Malcom Randall VA Medical Center (US)
- Ralph H. Johnson VA Medical Center (US)
- Weill Cornell Medicine (US)
- University of Virginia (US)
- University of Missouri (US)
- Florida College (US)
Publication Details
- Journal
- iScience
- Published
- 2025-10-04
- DOI
- https://doi.org/10.1016/j.isci.2025.113693
- Citations
- 1
- Primary Topic
- Vascular Malformations Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 1.39