title: Surgical considerations regarding giant dilations of the perivascular spaces.
abstract: OBJECTIVE
  Dilations of brain perivascular spaces (PVSs), also known as Virchow-Robin spaces, are routinely identified on magnetic resonance imaging studies of the brain and recognized as benign normal variants. Giant dilations occur only rarely and can be easily misdiagnosed as central nervous system tumors. The relevant surgical literature was reviewed to help establish indications for surgical intervention in these typically benign lesions.
  
  
  METHODS
  Giant dilations of the PVSs in 12 patients who had undergone surgery for several different indications were identified. Both clinical and radiographic presentations of these patients were reviewed along with the surgical procedures.
  
  
  CONCLUSIONS
  Dilations of the PVSs can become giant lesions that may necessitate surgical intervention to relieve mass effect or hydrocephalus. The relationship of these lesions to neurological symptoms such as tremor and seizures remains unclear.
authors.affiliation: Department of Neurological Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: House
authors.forename: Karen L
authors.initials: KL
authors.lastname: Salzman
authors.forename: Anne G
authors.initials: AG
authors.lastname: Osborn
authors.forename: Joel D
authors.initials: JD
authors.lastname: MacDonald
authors.forename: Randy L
authors.initials: RL
authors.lastname: Jensen
authors.forename: William T
authors.initials: WT
authors.lastname: Couldwell
mesh_terms: D000328:Adult; D020144:Basal Ganglia Cerebrovascular Disease / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D002540:Cerebral Cortex / Q000098:blood supply* / Q000473:pathology; D003399:Craniotomy; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic / Q000473:pathology / Q000601:surgery; D004292:Dominance, Cerebral / Q000502:physiology; D045604:Extracellular Fluid; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010841:Pia Mater / Q000473:pathology*; D012189:Retrospective Studies; D013788:Thalamus / Q000473:pathology / Q000601:surgery; D014696:Ventriculostomy