[Surgery for enlarged perivascular spaces: primary experience]

Perivascular spaces are cavities surrounding cerebral and spinal cord vessels and filled with cerebrospinal or intercellular fluid. Abnormal enlargement of these spaces can lead to neurological symptoms. Currently, there are no clear approaches to surgical treatment of this pathology. We set ourselves the task of analyzing the literature data, as well as presenting own clinical observations and sharing the experience of microsurgical treatment of this pathology.

We reviewed the PubMed databases between 2009 and 2024. We analyzed own small sample (n=5) of patients with dilated perivascular spaces who underwent microsurgical treatment between 2009 and 2024. Four patients underwent microsurgical cystoventriculostomy, one patient - microsurgical cystocysternostomy and biopsy.

Microsurgical cystoventriculostomy and cyst drainage were less effective than expected. Four out of five patients developed new neurological symptoms after surgery, while baseline symptoms did not significantly regress.

To date, cerebrospinal fluid shunting is still the main surgical method for dilated perivascular spaces accompanied by intracranial hypertension.