gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Lymphatic drainage from the mouse pituitary and brain

Meeting Abstract

  • Carolin Breymann - Klinik und Poliklinik für Neurochirurgie, Georg-August-Universität Göttingen
  • Alf Giese - Klinik und Poliklinik für Neurochirurgie, Johannes-Gutenberg-Universität Mainz, Deutschland
  • Patrizio Caturegli - Department for Pathology and Immunology, Johns Hopkins Medical School, Baltimore, USA
  • Angelika Gutenberg - Klinik und Poliklinik für Neurochirurgie, Georg-August-Universität Göttingen; Klinik und Poliklinik für Neurochirurgie, Johannes-Gutenberg-Universität Mainz, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 024

doi: 10.3205/14dgnc419, urn:nbn:de:0183-14dgnc4190

Published: May 13, 2014

© 2014 Breymann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Lymphatic drainage from brain has been clearly demonstrated to occur mainly via the nasal pathway, eventually reaching the cervical nodes in animal models. Its dynamics, as well as the anatomical route of the lymphatic drainage of the pituitary, has not been investigated, and both were the goal of our study.

Method: Pituitary glands of 12 mice were injected stereotactically with 5 μl of a saturated India ink solution. As control, same strain mice were injected into the right ventricle (n=14) using 10 μl India ink. To assess whether the cervical lymphatic drainage from the CSF was primary or rather secondary to a nasal pathway, 6 mice were injected with just 10 μl of ink into the posterior part of the nasal mucosa. For dynamic analysis of the lymphatic drainage mice of group 1 were surgically prepared before ink injection with a midline neck incision to expose the cervical lymph nodes. The lymphatic distribution of the dye was recorded macroscopically. Animals of group 2 were euthanized after 5, 10 or 20 minutes after injection, and distribution of the ink was histologically documented in decalcified paraffin blocks.

Results: CSF and nose revealed selective timely and anatomical lymphatic drainage: CSF drained mainly to the deep cervical nodes via a rapid route (3-7 minutes) along paravascular space mainly of the middle cerebral and carotid artery, followed by a delayed drainage (10-20 minutes) along the olfactory bulb through the cribriform plate and into lymphatics of the epithelium of nasal submucosa and to a minor fraction following the optic nerves to small lacunae between choroidea and retina, blackening the superficial cervical nodes. Ink injection to the nose lead to staining of submandibular superficial lymph nodes and salivary gland within 10 minutes. Deep cervical lymph nodes were only faintly coloured. Following pituitary injection, dye was seen along the perivascular spaces of the hypophyseal and carotid artery as well as the olfactory bulb and the nasal mucosa, leading to staining of both deep and superficial lymphatics.

Conclusions: The lymphatic drainage of the pituitary gland had not been shown previously. Pituitary drainage seems to occur via the “nasal” as well as the “CSF” pathway, using the superficial and deep lymphatics of the neck. An extensive and more rapid alternative pathway to the deep lymphatics of the neck is demonstrated, compatible with a prompt bulk flow drainage of the CSF to balance quick elevations of intracranial pressure.