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Pediatrics
Diagnosis
Brain
Cysts and Neoplasms
Enlarged Perivascular Spaces
Enlarged Perivascular Spaces
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Perivascular space (PVS)
              • Virchow-Robin space (VRS)

            • Definitions

              • Channels in subpial space that accompany penetrating arteries into brain

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Francis F et al: Perivascular spaces and their associations with risk factors, clinical disorders and neuroimaging features: a systematic review and meta-analysis. Int J Stroke. 4(4):359-71, 2019
                                          2. Hilal S et al: Enlarged perivascular spaces and cognition: a meta-analysis of 5 population-based studies. Neurology. 91(9):e832-42, 2018
                                          3. Laveskog A et al: Perivascular spaces in old age: assessment, distribution, and correlation with white matter hyperintensities. AJNR Am J Neuroradiol. 39(1):70-6, 2018
                                          4. Niazi M et al: Quantitative MRI of perivascular spaces at 3T for early diagnosis of mild cognitive impairment. AJNR Am J Neuroradiol. 39(9):1622-8, 2018
                                          5. Zhang X et al: Brain atrophy correlates with severe enlarged perivascular spaces in basal ganglia among lacunar stroke patients. PLoS One. 11(2):e0149593, 2016
                                          6. Potter GM et al: Enlarged perivascular spaces and cerebral small vessel disease. Int J Stroke. 10(3):376-81, 2015
                                          7. Huijts M et al: Basal ganglia enlarged perivascular spaces are linked to cognitive function in patients with cerebral small vessel disease. Curr Neurovasc Res. 11(2):136-41, 2014
                                          8. Vanderver A et al: Characteristic brain magnetic resonance imaging pattern in patients with macrocephaly and PTEN mutations. Am J Med Genet A. 164A(3):627-33, 2014
                                          9. Yakushiji Y et al: Topography and associations of perivascular spaces in healthy adults: the Kashima scan study. Neurology. 83(23):2116-23, 2014
                                          10. Caner B et al: Dilatation of Virchow-Robin perivascular spaces: report of 3 cases with different localizations. Minim Invasive Neurosurg. 51(1):11-4, 2008
                                          11. Carare RO et al: Solutes, but not cells, drain from the brain parenchyma along basement membranes of capillaries and arteries: significance for cerebral amyloid angiopathy and neuroimmunology. Neuropathol Appl Neurobiol. 34(2):131-44, 2008
                                          12. Kara S et al: Dilated perivascular spaces: an informative radiologic finding in Sanfilippo syndrome type A. Pediatr Neurol. 38(5):363-6, 2008
                                          13. Stephens T et al: Giant tumefactive perivascular spaces. J Neurol Sci. 266(1-2):171-3, 2008
                                          14. Kwee RM et al: Virchow-Robin spaces at MR imaging. Radiographics. 27(4):1071-86, 2007
                                          15. Groeschel S et al: Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature. Neuroradiology. 2006
                                          16. Salzman KL et al: Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 26(2):298-305, 2005
                                          17. Papayannis CE et al: Expanding Virchow Robin spaces in the midbrain causing hydrocephalus. AJNR Am J Neuroradiol. 24(7):1399-403, 2003
                                          18. Ozturk MH et al: Comparison of MR signal intensities of cerebral perivascular (Virchow-Robin) and subarachnoid spaces. J Comput Assist Tomogr. 26(6):902-4, 2002
                                          19. Song CJ et al: MR imaging and histologic features of subinsular bright spots on T2-weighted MR images: Virchow-Robin spaces of the extreme capsule and insular cortex. Radiology. 214(3):671-7, 2000
                                          20. Adachi M et al: Dilated Virchow-Robin spaces: MRI pathological study. Neuroradiology. 40(1):27-31, 1998
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Perivascular space (PVS)
                                                      • Virchow-Robin space (VRS)

                                                    • Definitions

                                                      • Channels in subpial space that accompany penetrating arteries into brain

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Francis F et al: Perivascular spaces and their associations with risk factors, clinical disorders and neuroimaging features: a systematic review and meta-analysis. Int J Stroke. 4(4):359-71, 2019
                                                                                  2. Hilal S et al: Enlarged perivascular spaces and cognition: a meta-analysis of 5 population-based studies. Neurology. 91(9):e832-42, 2018
                                                                                  3. Laveskog A et al: Perivascular spaces in old age: assessment, distribution, and correlation with white matter hyperintensities. AJNR Am J Neuroradiol. 39(1):70-6, 2018
                                                                                  4. Niazi M et al: Quantitative MRI of perivascular spaces at 3T for early diagnosis of mild cognitive impairment. AJNR Am J Neuroradiol. 39(9):1622-8, 2018
                                                                                  5. Zhang X et al: Brain atrophy correlates with severe enlarged perivascular spaces in basal ganglia among lacunar stroke patients. PLoS One. 11(2):e0149593, 2016
                                                                                  6. Potter GM et al: Enlarged perivascular spaces and cerebral small vessel disease. Int J Stroke. 10(3):376-81, 2015
                                                                                  7. Huijts M et al: Basal ganglia enlarged perivascular spaces are linked to cognitive function in patients with cerebral small vessel disease. Curr Neurovasc Res. 11(2):136-41, 2014
                                                                                  8. Vanderver A et al: Characteristic brain magnetic resonance imaging pattern in patients with macrocephaly and PTEN mutations. Am J Med Genet A. 164A(3):627-33, 2014
                                                                                  9. Yakushiji Y et al: Topography and associations of perivascular spaces in healthy adults: the Kashima scan study. Neurology. 83(23):2116-23, 2014
                                                                                  10. Caner B et al: Dilatation of Virchow-Robin perivascular spaces: report of 3 cases with different localizations. Minim Invasive Neurosurg. 51(1):11-4, 2008
                                                                                  11. Carare RO et al: Solutes, but not cells, drain from the brain parenchyma along basement membranes of capillaries and arteries: significance for cerebral amyloid angiopathy and neuroimmunology. Neuropathol Appl Neurobiol. 34(2):131-44, 2008
                                                                                  12. Kara S et al: Dilated perivascular spaces: an informative radiologic finding in Sanfilippo syndrome type A. Pediatr Neurol. 38(5):363-6, 2008
                                                                                  13. Stephens T et al: Giant tumefactive perivascular spaces. J Neurol Sci. 266(1-2):171-3, 2008
                                                                                  14. Kwee RM et al: Virchow-Robin spaces at MR imaging. Radiographics. 27(4):1071-86, 2007
                                                                                  15. Groeschel S et al: Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature. Neuroradiology. 2006
                                                                                  16. Salzman KL et al: Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 26(2):298-305, 2005
                                                                                  17. Papayannis CE et al: Expanding Virchow Robin spaces in the midbrain causing hydrocephalus. AJNR Am J Neuroradiol. 24(7):1399-403, 2003
                                                                                  18. Ozturk MH et al: Comparison of MR signal intensities of cerebral perivascular (Virchow-Robin) and subarachnoid spaces. J Comput Assist Tomogr. 26(6):902-4, 2002
                                                                                  19. Song CJ et al: MR imaging and histologic features of subinsular bright spots on T2-weighted MR images: Virchow-Robin spaces of the extreme capsule and insular cortex. Radiology. 214(3):671-7, 2000
                                                                                  20. Adachi M et al: Dilated Virchow-Robin spaces: MRI pathological study. Neuroradiology. 40(1):27-31, 1998