The glymphatic and meningeal lymphatic systems may converge, connecting traumatic brain injury progression with chronic traumatic encephalopathy onset

Chronic traumatic encephalopathy (CTE) is strongly linked to repetitive concussive traumatic brain injuries (TBIs).

• CTE is characterized by the buildup of hyperphosphorylated tau (P-tau) around blood vessels in the brain.
• Disruptions in the brain's fluid clearance systems, particularly the glymphatic and meningeal lymphatic pathways, may drive the onset and progression of CTE.
• TBI can impair the exchange of interstitial fluid and cerebrospinal fluid, leading to the accumulation of harmful proteins and increased inflammation.
• Meningeal lymphatic dysfunction may hinder cerebrospinal fluid drainage, contributing to ongoing neuroinflammation and further glymphatic failure.
• The effectiveness of these fluid clearance systems may vary with age, influencing both immediate and long-term outcomes after injury.
• Differences in brain fluid clearance between species complicate the translation of findings from rodent models to humans.

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