The Blood-Brain Barrier
Initial investigations into the blood-brain barrier (BBB) date back to the 19th century. Since that time, the BBB has been extensively studied to develop a greater understanding of the role of this structure in molecular transport, drug delivery, and neurological diseases. The BBB consists of a neurovascular unit that orchestrates a complex system of exchange, transport, and clearance through interactions with intravascular contents, cerebrospinal fluid, and the brain parenchyma. Recent research has focused on the effect of compromise to the BBB in both the pathogenesis and treatment of neuroinflammatory and neurodegenerative disorders, including stroke, epilepsy, traumatic brain injury, central nervous system infections, Parkinson disease, Alzheimer disease, and multiple sclerosis. There are also ongoing trials exploiting BBB disruption in the setting of both primary and metastatic brain tumors to discover new ways to enhance imaging acquisition and drug delivery. This chapter provides a review of the anatomic structure, function, and pathology of the BBB with additional focus on current translational research in neurosurgery.
