Surgical considerations regarding giant dilations of the perivascular spaces.
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.
House
Paul
P
Department of Neurological Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
Salzman
Karen L
KL
Osborn
Anne G
AG
MacDonald
Joel D
JD
Jensen
Randy L
RL
Couldwell
William T
WT
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