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Brain fluid clearance pathways in cerebrovascular disease

Perivascular spaces and the role of brain fluid clearance pathways are becoming increasing areas of interest and awareness as more is learned about their clinical implications for stroke and small vessel disease. Joanna Wardlaw, CBE, MD, FRCP, FRSE, FMedSci, University of Edinburgh, Edinburgh, Scotland, UK, discusses what we know about these systems and methods to detect emerging signs of problems within them. With imaging techniques like MRI, it is now possible to see deficits in fluid clearance systems, such as enlarged perivascular spaces. Ongoing research is aiming to elucidate the role of these pathways, both in acute stroke and diffuse cerebrovascular disease, and if there are ways to improve clearance to help prevent progressive deterioration. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.