title: Giant cystic Virchow-Robin spaces with adjacent white matter signal alteration.
abstract: Perivascular spaces surround the small arteries and veins as they enter into the brain parenchyma from the subarachnoid spaces. Also called as Virchow-Robin spaces, these are prominent in the basal ganglia and high convexity white matter of the elderly. Occasionally VR spaces may get massively enlarged and may mimic a cystic mass lesion. The typical CSF-like signal intensity of the cysts and location on MRI, in the absence of a neurological abnormality help in the diagnosis of the giant VR spaces and thus biopsy is avoided. Typically there is no significant adjacent brain abnormality; however FLAIR images may sometimes reveal perilesional white matter hyperintensity, which may be an indication of gliosis due to the mass effect of the lesion. Such a signal alteration should not deter one from making a diagnosis of giant Virchow-Robin spaces when the rest of the imaging findings are typical. We describe a case of a 50-year-old female with incidental giant Virchow-Robin spaces in the right hemispheric subcortical white matter with adjacent white matter hyperintense signal intensity on T2-weighted and FLAIR images.
authors.affiliation: Sher-I-Kashmir Institute of Medical Sciences, Deparatment of Radiodiagnosis & Imaging, Srinagar, India. nisar.wani@yahoo.com
authors.forename: Nisar A
authors.initials: NA
authors.lastname: Wani
authors.forename: Farooq
authors.initials: F
authors.lastname: Mir
authors.forename: Irshad M
authors.initials: IM
authors.lastname: Bhat
authors.forename: Tariq
authors.initials: T
authors.lastname: Gojwari
authors.forename: Salma
authors.initials: S
authors.lastname: Bhat
mesh_terms: D001921:Brain / Q000098:blood supply* / Q000473:pathology*; D002536:Cerebral Arteries / Q000473:pathology; D003560:Cysts / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D056784:Leukoencephalopathies / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D013346:Subarachnoid Space / Q000473:pathology