Expanding Virchow Robin spaces in the midbrain causing hydrocephalus (original) (raw)
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Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
The Virchow-Robin spaces (VRSs), which are often incidentally observed in modern structural neuroimaging examinations, are small cystic cavities that usually surround the small arteries and arterioles at the level of basal ganglia, the anterior perforated substance and the thalamic-mesencephalic junction. Typically, they have similar physicochemical characteristics to cerebral spinal fluid (CSF) and there is no contrast enhancement on brain CT and MRI images. Its real meaning is unknown, although some contemporary studies have suggested that it might be related to certain traumatic brain injury or several other central nervous system (CNS) disorders, as degenerative diseases. Occasionally, some wide and atypical VRS may be mistaken for primary cystic brain tumors, especially in the context of large and symptomatic lesions, multiple clustered cysts, cortical lesions and if there is adjacent reactive gliosis. The present paper reports four patients who were affected by atypical VRS mi...
Giant Cystic Widening of Virchow-Robin Spaces: An Anatomofunctional Study
American Journal of Neuroradiology, 2007
We describe 2 patients with unusual white matter cystic dilations, which could correspond to widening of the perivascular spaces. They underwent morphologic MR imaging with tractography, functional MR imaging (fMRI), and neuropsychological evaluation. fMRI examination showed no functional reorganization of cortical areas. Tractography showed an apparent decrease of white matter tract vectors into the regions of concern. Findings of the neuropsychological examination were normal. It seems that even an extensive cystic dilation of white matter does not deteriorate brain function.
Giant dilatations of virchow-robin spaces in the midbrain. MRI aspects and review of the literature
The neuroradiology journal, 2012
Virchow-Robin spaces are lesions often seen in the brain parenchyma but their etiopathogenesis remains unsettled. Giant Virchow-Robin spaces placed in the midbrain are extremely rare. We describe three patients with a diagnosis of giant Virchow-Robin spaces in the midbrain, and their clinical and radiologic findings. We reviewed the literature in terms of the etiopathology, anatomic and radiologic appearance and differential diagnosis of the giant Virchow-Robin spaces. The diagno-stic role of the high Tesla magnetic resonance devices and new sequences techniques such as three dimensional isotropic acquisition and diffusion tensor imaging were also evaluated in this case series.
Dilated Virchow-Robin Spaces Mimicking a Brainstem Arteriovenous Malformation
Journal of neurosciences in rural practice
Virchow-Robin spaces (VRS) are ubiquitous and commonly observed as the resolution of magnetic resonance imaging (MRI) continues to improve. The function of VRS and the etiology of their dilation is still a subject of research. Diagnosing dilated VRS (dVRS) can be challenging because they may appear similar to other pathologies such as cystic neoplasms, infectious cysts, and even arteriovenous malformations (AVMs) on certain MRI pulse sequences. We reported a unique case of brainstem dVRS mimicking an AVM. Furthermore, the extensive pontine involvement of our patient's lesion is rarely described in neurosurgical literature. Understanding the imaging characteristics of dVRS is critical to accurately diagnose these lesions and avoid unnecessary tests and procedures.
Giant tumefactive perivascular spaces mimicking a brain mass lesion: Report of three cases
Clinical and Translational Neuroscience
Virchow–Robin spaces or perivascular spaces are pial-lined fluid-filled interstitial spaces recognized throughout brain parenchyma along the path of penetrating vessels. Occasionally, they may become enlarged, cause mass effect, and be mistaken for cystic neoplasms or infections. We report three cases of giant tumefactive perivascular spaces (GTPVS) incidentally found at brain magnetic resonance imaging (MRI). The lesions were multilocular cystic-appearing, isointense to cerebrospinal fluid on all pulse sequences, and did not enhance. They were located both in typical and atypical locations and in one case associated with hydrocephalus. We describe the key features of GTPVS on MRI and illustrate the need to acknowledge and promptly recognize these entities in daily practice in order to avoid unnecessary treatment.
Widening of Virchow-Robin spaces in the brain stem causing hemifacial spasm
European Journal of Radiology Extra, 2009
We report a patient who presented with dilated Virchow-Robin spaces causing hemifacial spasm concordant with its location on magnetic resonance imaging. Virchow-Robin spaces were interpreted as the cause of hemifacial spasm because it occupied the left side of pons and it was adjacent to the localization of the nucleus of the left facial nerve. We presume that probable chronic mild compression of Virchow-Robin spaces on the nucleus of the left facial nerve has caused hemifacial spasm. Regarding our case, widened V-R spaces seem to have the potential to cause symptoms relating to their location.