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Area of Science:

  • Neurology
  • Radiology
  • Geriatrics

Background:

  • Enlarged Virchow-Robin spaces in the striatum, termed Swiss cheese striatum (SCS), are occasionally observed on MRI in elderly individuals.
  • The clinical significance and impact of SCS remain largely unknown.

Purpose of the Study:

  • To investigate the clinical features associated with Swiss cheese striatum (SCS) detected via magnetic resonance imaging (MRI).

Main Methods:

  • A retrospective case-control study compared severe SCS cases (n=27) with matched controls (n=52) using MRI data from 2000-2007.
  • Medical records were reviewed for clinical data including parkinsonism, dementia, and vascular risk factors.
  • MRI scans were assessed for leukoaraiosis, central atrophy, and cortical atrophy.

Main Results:

  • No significant differences in the rates of parkinsonism or dementia were found between severe SCS cases and controls.
  • Vascular risk factors did not differ significantly between the groups.
  • SCS showed a significant correlation with the degree of leukoaraiosis (P<.001), suggesting a link to cerebrovascular processes.

Conclusions:

  • Marked cribriform change in the striatum (SCS) is not associated with the development of extrapyramidal disorders like parkinsonism.
  • The association of SCS with leukoaraiosis suggests it is part of a generalized cerebrovascular process.
  • Clinical symptoms should be interpreted with caution when attributed solely to the presence of SCS on MRI.