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Enlarged Perivascular Spaces
Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Perivascular spaces (PVSs)
            • Synonyms

              • Virchow-Robin spaces
            • Definitions

              • Pial-lined interstitial fluid (ISF) -filled structures that accompany penetrating arteries but do not communicate directly with subarachnoid space

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Branch BC et al: Posterior fossa giant tumefactive perivascular spaces: 8-year follow-up in an adolescent. Surg Neurol Int. 6:2, 2015
                                            2. Kilsdonk I et al: Perivascular spaces in MS patients at 7 Tesla MRI: A marker of neurodegeneration? Mult Scler. 21(2):155-62, 2015
                                            3. Lochhead JJ et al: Rapid transport within cerebral perivascular spaces underlies widespread tracer distribution in the brain after intranasal administration. J Cereb Blood Flow Metab. 35(3):371-81, 2015
                                            4. Ramirez J et al: Visible Virchow-Robin spaces on magnetic resonance imaging of Alzheimer's disease patients and normal elderly from the Sunnybrook Dementia Study. J Alzheimers Dis. 43(2):415-24, 2015
                                            5. Bouvy WH et al: Visualization of perivascular spaces and perforating arteries with 7 T magnetic resonance imaging. Invest Radiol. 49(5):307-13, 2014
                                            6. Eluvathingal Muttikkal TJ et al: Spontaneous regression and recurrence of a tumefactive perivascular space. Neuroradiol J. 27(2):195-202, 2014
                                            7. Hawkes CA et al: Failure of perivascular drainage of β-amyloid in cerebral amyloid angiopathy. Brain Pathol. 24(4):396-403, 2014
                                            8. Hladky SB et al: Mechanisms of fluid movement into, through and out of the brain: evaluation of the evidence. Fluids Barriers CNS. 11(1):26, 2014
                                            9. Roelz R et al: Giant perivascular spaces causing hemiparesis successfully treated by cystoventriculoperitoneal shunt. Br J Neurosurg. 1-3, 2014
                                            10. Saylisoy S et al: Is there a connection between perivascular space and subarachnoid space? J Comput Assist Tomogr. 38(1):33-5, 2014
                                            11. Yakushiji Y et al: Topography and associations of perivascular spaces in healthy adults: the Kashima scan study. Neurology. 83(23):2116-23, 2014
                                            12. Martinez-Ramirez S et al: Topography of dilated perivascular spaces in subjects from a memory clinic cohort. Neurology. 80(17):1551-6, 2013
                                            13. Stephens T et al: Giant tumefactive perivascular spaces. J Neurol Sci. 266(1-2):171-3, 2008
                                            14. Salzman KL et al: Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 26(2):298-305, 2005
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Perivascular spaces (PVSs)
                                                      • Synonyms

                                                        • Virchow-Robin spaces
                                                      • Definitions

                                                        • Pial-lined interstitial fluid (ISF) -filled structures that accompany penetrating arteries but do not communicate directly with subarachnoid space

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Angiographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Branch BC et al: Posterior fossa giant tumefactive perivascular spaces: 8-year follow-up in an adolescent. Surg Neurol Int. 6:2, 2015
                                                                                      2. Kilsdonk I et al: Perivascular spaces in MS patients at 7 Tesla MRI: A marker of neurodegeneration? Mult Scler. 21(2):155-62, 2015
                                                                                      3. Lochhead JJ et al: Rapid transport within cerebral perivascular spaces underlies widespread tracer distribution in the brain after intranasal administration. J Cereb Blood Flow Metab. 35(3):371-81, 2015
                                                                                      4. Ramirez J et al: Visible Virchow-Robin spaces on magnetic resonance imaging of Alzheimer's disease patients and normal elderly from the Sunnybrook Dementia Study. J Alzheimers Dis. 43(2):415-24, 2015
                                                                                      5. Bouvy WH et al: Visualization of perivascular spaces and perforating arteries with 7 T magnetic resonance imaging. Invest Radiol. 49(5):307-13, 2014
                                                                                      6. Eluvathingal Muttikkal TJ et al: Spontaneous regression and recurrence of a tumefactive perivascular space. Neuroradiol J. 27(2):195-202, 2014
                                                                                      7. Hawkes CA et al: Failure of perivascular drainage of β-amyloid in cerebral amyloid angiopathy. Brain Pathol. 24(4):396-403, 2014
                                                                                      8. Hladky SB et al: Mechanisms of fluid movement into, through and out of the brain: evaluation of the evidence. Fluids Barriers CNS. 11(1):26, 2014
                                                                                      9. Roelz R et al: Giant perivascular spaces causing hemiparesis successfully treated by cystoventriculoperitoneal shunt. Br J Neurosurg. 1-3, 2014
                                                                                      10. Saylisoy S et al: Is there a connection between perivascular space and subarachnoid space? J Comput Assist Tomogr. 38(1):33-5, 2014
                                                                                      11. Yakushiji Y et al: Topography and associations of perivascular spaces in healthy adults: the Kashima scan study. Neurology. 83(23):2116-23, 2014
                                                                                      12. Martinez-Ramirez S et al: Topography of dilated perivascular spaces in subjects from a memory clinic cohort. Neurology. 80(17):1551-6, 2013
                                                                                      13. Stephens T et al: Giant tumefactive perivascular spaces. J Neurol Sci. 266(1-2):171-3, 2008
                                                                                      14. Salzman KL et al: Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 26(2):298-305, 2005