Giant Virchow-Robin spaces as an incidental finding in a patient with parkinsonism

Virchow-Robin spaces are perivascular spaces that surround small arteries and arterioles as they enter the brain parenchyma. They are usually normal findings on MRI of healthy people. Rarely, Virchow-Robin spaces look strikingly enlarged, causing mass effect and unusual cystic conformations that may be misinterpreted as other pathologic processes, such as a cystic neoplasm. Here, we describe a 52-year-old woman in whom brain magnetic resonance imaging (MRI), performed to evaluate Parkinsonism, incidentally found giant Virchow-Robins space or Swiss cheese brain syndrome. In our patient, it seems that the giant Virchow-Robin spaces have been found incidentally and are not associated with the patient's Parkinsonism symptoms.