Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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December 25, 2014
Giant Virchow-Robin Spaces
- Virchow-Robin (VR) spaces are perivascular spaces that surround the blood vessels as they course from the subarachnoid space through the brain.
- They may become enlarged, assume bizarre configurations, and cause mass effect.
- Knowledge of their characteristic distribution and signal intensity helps in differentiating them from different pathologic conditions.
- Key Diagnostic Features
- VR spaces are isointense to cerebrospinal fluid on all MRI sequences.
- They are typically seen along the lenticulostriate arteries in the basal ganglia, the perforating medullary arteries in the high convexities of the cerebral white matter, or in the midbrain.
- DDx:
- Enlarged perivascular spaces: Mucopolysaccharidoses, cryptococcal meningitis
- Alternative cystic pathologies: Infection (eg, neurocysticercosis), cystic neoplasm, lacunar infarct, cystic encephalomalacia
- Rx: Observation
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