{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:40:23Z","timestamp":1792510823776,"version":"4.5.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/ http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Traumatic brain injury initiates secondary processes that may persist long after the initial mechanical insult. These processes may be amplified when tissue fluid, cellular debris, inflammatory mediators, metabolites, and abnormal proteins accumulate faster than the brain can redistribute or eliminate them. The relevant clearance apparatus is a serial\u2013parallel network comprising cerebrospinal fluid\u2013interstitial fluid exchange, perivascular transport, brain\u2013meningeal interfaces, meningeal lymphatic vessels, and cranial, spinal, and cervical outflow pathways. Traumatic brain injury may disrupt this network through altered aquaporin-4 polarization, blood\u2013brain barrier dysfunction, edema, pressure abnormalities, disturbed sleep and autonomic regulation, and neuroinflammation. This dysfunction does not necessarily represent a uniform reduction in flow; rather, it may involve phase- and phenotype-specific transport bottlenecks. This review integrates these mechanisms within an injury\u2013clearance\u2013repair framework, evaluates available imaging biomarkers, and classifies therapeutic evidence according to the directness of transport-target engagement. Current evidence remains predominantly preclinical, and most non-invasive interventions require mechanistic validation specifically in traumatic brain injury. Translation will depend on compartment-specific biomarkers, phase-appropriate safety assessments, and the establishment of a causal link between transport correction, neural repair biology, and functional recovery. The therapeutic objective is not the indiscriminate enhancement of \u201cflow,\u201d but the restoration of coordinated transport across the rate-limiting step that constrains recovery.<\/jats:p>","DOI":"10.4103\/nrr.nrronline-d-26-00938","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:52:00Z","timestamp":1792507920000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Intracranial lymphatic dysfunction after traumatic brain injury: Imaging biomarkers, neural repair, and non-invasive modulation"],"prefix":"10.4103","author":[{"given":"Yuheng","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingliang","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9119-0115","authenticated-orcid":false,"given":"Rongcai","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0506-3356","authenticated-orcid":false,"given":"Tao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,20]]},"container-title":["Neural Regeneration Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/NRR.NRRONLINE-D-26-00938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:52:01Z","timestamp":1792507921000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/NRR.NRRONLINE-D-26-00938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/nrr.nrronline-d-26-00938","relation":{},"ISSN":["1673-5374","1876-7958"],"issn-type":[{"value":"1673-5374","type":"print"},{"value":"1876-7958","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"assertion":[{"value":"2026-09-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}