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Related Experiment Videos

Perivascular spaces: normal and giant.

Randy Fanous1, Mehran Midia

  • 1Department of Radiology, McMaster University, Hamilton, Ontario, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|March 14, 2007
PubMed
Summary
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Giant perivascular spaces (GPVSs) are distinct from normal perivascular spaces (PVSs). Recognizing characteristic MRI findings of GPVSs can prevent misdiagnosis and unnecessary procedures.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Perivascular spaces (PVSs) are anatomical structures surrounding cerebral blood vessels.
  • Normal PVSs play roles in brain immunology and lymphatic drainage.
  • Pathological giant perivascular spaces (GPVSs) can mimic other neurological conditions.

Purpose of the Study:

  • To differentiate normal PVSs from pathological GPVSs.
  • To describe the anatomy, physiology, and imaging findings of PVSs and GPVSs.
  • To explore the clinical features, pathogenesis, and diagnostic criteria for GPVSs.

Main Methods:

  • Review of anatomical and physiological data for normal PVSs.
  • Analysis of Magnetic Resonance Imaging (MRI) findings for both normal PVSs and GPVSs.

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  • Exploration of clinical presentations and pathogenetic mechanisms of GPVSs.

    • Main Results:

    • Normal PVSs have described anatomical and physiological roles.
    • GPVSs exhibit characteristic MRI features: isointense with cerebrospinal fluid, no contrast enhancement, non-calcified, and normal adjacent brain parenchyma.
    • Specific location along penetrating vessels is a key diagnostic indicator for GPVSs.

    Conclusions:

    • GPVSs possess pathognomonic MRI findings that aid in diagnosis.
    • Symptomatic GPVSs should not be confused with more severe pathologies.
    • Biopsy is unnecessary; neurosurgical intervention should be considered for symptomatic mass effect from GPVSs.