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Unusual widening of Virchow-Robin spaces: MR appearance

T Ogawa1, T Okudera, H Fukasawa

  • 1Department of Radiology and Nuclear Medicine, Research Institute of Brain and Blood Vessels, Akita, Japan.

Insights

Unusual widening of Virchow-Robin spaces in two patients revealed multiple cerebrospinal fluid-like cystic foci in the cerebral white matter. Biopsy confirmed these findings as enlarged Virchow-Robin spaces.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Virchow-Robin spaces (VRS) are normal perivascular spaces within the brain.
  • Enlarged VRS can be associated with various neurological conditions.

Observation:

  • Two patients presented with unusual widening of VRS.
  • Magnetic Resonance (MR) imaging revealed multiple cystic foci up to 2 cm in diameter.
  • These lesions were located along perforating medullary arteries in the cerebral white matter, predominantly in one hemisphere.

Findings:

  • The cystic foci exhibited signal intensity identical to cerebrospinal fluid across all MR pulse sequences.
  • Histopathological examination of biopsied white matter lesions confirmed them as enlarged Virchow-Robin spaces.

Implications:

  • This study highlights a specific MR imaging pattern associated with pathologically confirmed enlarged VRS.
  • Understanding this imaging phenotype is crucial for accurate differential diagnosis in neuroimaging.
  • Further research may elucidate the underlying causes and clinical significance of such extensive VRS enlargement.

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