title: Dilated perivascular spaces: hallmarks of mild traumatic brain injury.
abstract: OBJECTIVE
  Recent animal and human studies have shown an increased frequency of enlarged, high-convexity Virchow-Robin spaces (VRS) in several neurologic diseases, suggesting their role as neuroradiologic markers of inflammatory changes. The aim of this study was to determine the prevalence of high-convexity dilated VRS in mild traumatic brain injury (TBI).
  
  
  METHODS
  T2-weighted, T1-weighted, fluid-attenuated inversion recovery, and T2*-weighted gradient-echo brain MR images were acquired in 24 patients with TBI (10 women, 14 men; mean age, 33.6; range, 18.1-50.8 years) and 17 age- and sex-matched healthy control subjects (nine women, eight men; mean age, 32.8; range, 18.4-47.8 years). The mean interval after TBI was 3.6 days (range, 1-9 days) in 15 patients and 3.7 years (range, 0.6-13.4 years) in nine patients. Axial T2-weighted images were used to identify dilated VRS and to measure CSF volume; T1-weighted images were used to measure brain volume. Dilated VRS were identified as punctuate areas with CSF-like signal intensity in the high-convexity white matter.
  
  
  RESULTS
  Mean (+/- standard deviation) number of VRS was significantly higher in patients (7.1 +/- 4.6) than in controls (3.0 +/- 3.0, P = 0.002) [corrected] In controls, VRS were associated with age (R = 0.69, P < .001) whereas in patients, they neither correlated with brain and CSF volumes nor with age and the elapsed time from injury.
  
  
  CONCLUSIONS
  Our results suggest that the increased number of dilated VRS is a radiologic marker of mild head injury that is readily detectable on T2-weighted images. Because their number does not vary with time from injury, VRS probably reflect early and permanent brain changes.
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, NY 10016, USA.
authors.forename: Matilde
authors.initials: M
authors.lastname: Inglese
authors.forename: Elan
authors.initials: E
authors.lastname: Bomsztyk
authors.forename: Oded
authors.initials: O
authors.lastname: Gonen
authors.forename: Lois J
authors.initials: LJ
authors.lastname: Mannon
authors.forename: Robert I
authors.initials: RI
authors.lastname: Grossman
authors.forename: Henry
authors.initials: H
authors.lastname: Rusinek
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D013997:Time Factors