Regression of dilated perivascular spaces of the brain (original) (raw)
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Magnetic Resonance Imaging Features of Tumefactive Perivascular Spaces
Cyprus Journal of Medical Sciences, 2020
The perivascular spaces (PVSs) are pia-lined potential spaces filled with interstitial fluid (ISF) and form a network throughout the brain, which is a part of glymphatic system and helps to derange of metabolites from cerebral parenchyma. The enlarged PVSs are the most common cystic lesion of the brain and gradually become prominent with age. Literally, tumefactive PVS is the giant enlargement of PVS, measuring 15 mm and more in size, and thought to be result of blocking of the outlet of ISF for any reason. Typically, they tend to from clusters of cysts, but tumefactive forms are usually solitary. They usually have moderate mass effect and can cause obstructive hydrocephalus when located in mesencephalothalamic region. Although they don't contain cerebrospinal fluid (CSF), they have similar signal to CSF on all magnetic resonance imaging (MRI) sequences and do not enhance. These MRI features are very useful for their differential diagnosis from other congenital, infectious, ischemic and tumoral cystic/necrotic lesions. The precise diagnosis of PVS is critical to prevent patients with "leave-me-alone" lesions, from unnecessary surgical interventions.
Imaging of Intracranial Space Occupying Lesions
International Journal of Medical and Biomedical Studies, 2021
Introduction: With advanced MRI techniques such as perfusion, diffusion, and spectroscopy, it is now possible to differentiate between various intracranial lesions. Materials and Methods: This prospective cohort study was conducted on 50 patients referred by various clinical departments with clinical suspicion of intracranial space occupying lesions, evaluated by computed tomography & magnetic resonance imaging. Result: Solitary lesions were present in 35 patients (70%) & multiple lesions in 15 patients (30%). 68.00% lesions were Supratentorial & 32.00% infratentorial in location. Most common supratentorial location in adults was frontal lobe 40% followed by parietal lobe 30%. Most common supratentorial locations in children were frontal lobe. Infratentorially, cerebellum & posterior fossa were found to be most common location in adults & children respectively. Supratentorial lesions were most common both in adults & children. 60% lesions were intraaxial & 40 % extra axial in locati...
Perivascular spaces in the brain: anatomy, physiology and pathology
Perivascular spaces include a variety of passageways around arterioles, capillaries and venules in the brain, along which a range of substances can move. Although perivascular spaces were first identified over 150 years ago, they have come to prominence recently owing to advances in knowledge of their roles in clearance of interstitial fluid and waste from the brain, particularly during sleep, and in the pathogenesis of small vessel disease, Alzheimer disease and other neurodegenerative and inflammatory disorders. Experimental advances have facilitated in vivo studies of perivascular space function in intact rodent models during wakefulness and sleep, and MRI in humans has enabled perivascular space morphology to be related to cognitive function, vascular risk factors, vascular and neurodegenerative brain lesions, sleep patterns and cerebral haemodynamics. Many questions about perivascular spaces remain, but what is now clear is that normal perivascular space function is important for maintaining brain health. Here, we review perivascular space anatomy, physiology and pathology, particularly as seen with MRI in humans, and consider translation from models to humans to highlight knowns, unknowns, controversies and clinical relevance.
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.
Disproportionate subarachnoid space hydrocephalus-outcome and perivascular space
Annals of clinical and translational neurology, 2014
We sought to identify the prevalence of MRI features of disproportionately enlarged subarachnoid space hydrocephalus in possible idiopathic normal pressure hydrocephalus (DESH-iNPH) and to describe the clinico-radiological features and outcomes of a community-based investigation (The Vienna Trans-Danube Aging study). Of the 697 inhabitants (all 75 years old), 503 completed extensive neurological examinations at baseline and were followed up every 30 months thereafter with MRIs, mini-mental state examination (MMSE), and the Unified Parkinson Disease Rating Scale-Motor Section (UPDRSM). The DESH-iNPH participant data were compared with the data from participants with Evans index ratios >0.3 (ex vacuo hydrocephalus), cerebral small-vessel diseases, and normal MRIs. The widening of perivascular space was also evaluated by MRI in these groups. Eight participants with DESH-iNPH (1.6%) and 76 with ex vacuo hydrocephalus (16.1%) at baseline were identified. The mean MMSE in DESH-iNPH, ex...
Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease
Stroke, 2010
Background and Purpose-Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities, markers of established small vessel disease. Materials and Methods-We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched nonstroke control subjects were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0 to 4 (0ϭnone, 4ϭϾ40) on T2-weighted MRI and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and control subjects and assessed associations with vascular risk factors and white matter hyperintensities. Results-We recruited 350 patients; 129 lacunar, 124 cortical stroke, and 97 age-matched control subjects. Adjusting for vascular risk factors and white matter hyperintensities, total enlarged perivascular spaces were associated with lacunar stroke subtype (Pϭ0.04) in the acute stroke group (nϭ253); basal ganglia enlarged perivascular spaces were associated with lacunar stroke subtype (Pϭ0.003), deep (Pϭ0.02) and periventricular white matter hyperintensities (Pϭ0.01); in all 350 subjects, total enlarged perivascular spaces were associated with deep (PϽ0.001) and periventricular (PϽ0.001) white matter hyperintensities.
https://www.ijhsr.org/IJHSR\_Vol.8\_Issue.4\_April2018/IJHSR\_Abstract.031.html, 2018
Intracranial space occupying lesions (ICSOL) represent one of the most commonly encountered abnormalities in brain. The availability of computed tomography (CT) and conventional magnetic resonance imaging (MRI) have revolutionised the approach towards diagnosis and management of intracranial lesions. Majority of intracranial lesions can be reliably diagnosed on conventional MRI. However many times it is difficult to differentiate brain pathologies on the basis of CT scan or conventional MRI. In such cases, advanced MRI sequences such as diffusion weighted imaging (DWI), perfusion weighted imaging (PWI) and proton magnetic resonance spectroscopy (MRS) can be helpful in making a reliable and accurate diagnosis. Herein, we describe importance of advanced MRI sequences in diagnosing various ICSOLs which were extremely hard and confusing to differentiate on conventional MRI.