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Regression of dilated perivascular spaces of the brain

Surgical and Radiologic Anatomy volume 32, pages 555–561 (2010)Cite this article

Abstract

Purpose

Perivascular, or Virchow–Robin, spaces of the brain represent interstitial fluid-filled spaces continuous with subpial spaces, and not invagination of cerebrospinal fluid-filled subarachnoid spaces. Regression of a dilated, or even giant, perivascular space occurs rarely. The purpose of this paper is to describe magnetic resonance imaging evidence of complete regression of dilated perivascular spaces (dPVSs).

Methods

Patient 1 was a 76-year-old woman with right hemiparesis and aphasia from a left cranial vault meningioma infiltrating the superior sagittal sinus, and a left temporal lobe giant perivascular space. Patient 2 was a 70-year-old man with pituitary apoplexy, vasospasm, cerebral ischemia, and two dPVSs, one in the right temporal lobe, and one in the left anterior perforate substance. Patient 3 was a 78-year-old man with a generalized seizure, and a right temporal lobe dPVS.

Results

In all the patients, temporal lobe giant or dPVSs underwent regression, following meningioma subtotal resection (patient 1) or pituitary lesion shrinkage (patient 2), or spontaneously (patient 3). In patient 2, the left anterior perforate substance dPVS was unchanged.

Conclusions

Temporal lobe giant or dPVSs may regress, eventually together with resection or regression of intracranial tumors, also distant from the PVSs. Cerebral edema does not seem the only factor influencing dilatation of PVSs.

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Acknowledgments

We thank Tiziana Caselli, radiologist technician, from the Unità Operativa Complessa di Neuroimmagini e Neurointerventistica, Dipartimento di Neuroscienze, Azienda Ospedaliera Universitaria Senese, Policlinico “Santa Maria alle Scotte”, Siena, Italy, for her assistance, and Roberto Faleri from the Central Library, School of Medicine, University of Siena, Policlinico “Santa Maria alle Scotte”, Siena, Italy, for providing references for the preparation of this article.

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Affiliations

  1. Unità Operativa Complessa di Neuroimmagini e Neurointerventistica, Dipartimento di Neuroscienze, Policlinico “Santa Maria alle Scotte”, Azienda Ospedaliera Universitaria Senese, Viale Mario Bracci, 16, 53100, Siena, Italy

    Alfonso Cerase, Ignazio Maria Vallone & Carlo Venturi

  2. Struttura Complessa di Neuroradiologia, Dipartimento di Neuroscienze, Azienda Ospedaliera, “Gaetano Rummo”, Via dell’Angelo, 1, 82100, Benevento, Italy

    Carmine Franco Muccio

  3. Unità Operativa Complessa di Neurochirurgia Ospedaliera, Dipartimento di Neuroscienze, Policlinico “Santa Maria alle Scotte”, Azienda Ospedaliera Universitaria Senese, Viale Mario Bracci, 16, 53100, Siena, Italy

    Carlo Petrini

  4. Clinica Neurochirurgica, Dipartimento di Scienze Oftalmologiche e Neurochirurgiche, Policlinico “Santa Maria alle Scotte”, Università di Siena, Viale Mario Bracci, 16, 53100, Siena, Italy

    Giorgio Signori

Authors
  1. Alfonso Cerase
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  2. Ignazio Maria Vallone
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  3. Carmine Franco Muccio
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  4. Carlo Petrini
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  5. Giorgio Signori
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  6. Carlo Venturi
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Correspondence to Alfonso Cerase.

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Cerase, A., Vallone, I.M., Muccio, C.F. et al. Regression of dilated perivascular spaces of the brain. Surg Radiol Anat 32, 555–561 (2010). https://doi.org/10.1007/s00276-009-0603-y

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  • DOI: https://doi.org/10.1007/s00276-009-0603-y

Keywords

  • Brain
  • Cerebrospinal fluid
  • Perivascular spaces
  • Magnetic resonance imaging