Introduction: This study characterized the intellectual structure and emerging clinical themes at the intersection of glymphatic research and neurosurgery, with particular attention to the field’s movement from a predominantly macroscopic cerebrospinal-fluid framework toward perivascular and parenchymal transport concepts.
Methods: Bibliographic metadata for 317 documents indexed in the Web of Science Core Collection from 2015 through the first quarter of 2026 were analyzed with the R-based bibliometrix package. Co-word analysis used Author Keywords after lower-case conversion, whitespace trimming, and exact-string deduplication; semantic, plural, spacing, and hyphen variants were not consolidated. Network centrality and community detection identified influential lexical nodes and thematic clusters. Results involving 2026 were interpreted descriptively because the year was incomplete.
Results: The dataset included 317 documents from 171 sources, 2,199 authors, and 10,694 cited references. Three thematic clusters were identified: acute neurosurgical insults and aquaporin-4-related clearance impairment; clinical translation and neuroimaging, including magnetic resonance imaging and diffusion tensor image analysis along the perivascular space (DTI-ALPS); and chronic hydrocephalus-neurodegeneration research linking idiopathic normal pressure hydrocephalus, dementia, and shunt-related management. Because 2026 was incomplete, no complete-period annual growth rate was reported.
Discussion and Conclusion: The network maps a research field increasingly integrating perivascular transport with established pressure-volume concepts. DTI-ALPS should be interpreted as a localized, structure-dependent diffusion biomarker rather than a direct measure of whole-brain glymphatic clearance. Proposed applications in surgical selection and outcome prediction require prospective clinical validation.
Keywords: Aquaporin 4; Bibliometrics; Diffusion tensor imaging; Glymphatic system; Hydrocephalus, normal pressure; Neurosurgery
