Abstract
A perivascular space (PVS) or a Virchow-Robin space is a typically narrow tract that is the drainage pathway for the cerebral parenchyma. As there is no lymphatic system within the cerebrum, the PVSs drain interstitial/extracellular fluid peripherally outward to the subarachnoid space (SAS) but are thought not to communicate directly with the SAS. PVSs are also termed Virchow-Robin spaces, which surround small perforating arteries in multiple locations. They have also been described as potential spaces created by leptomeninges that penetrate the cerebral parenchyma and surround blood vessels. The literature suggests that tiny, normal PVSs may be seen in up to 80 % of the pediatric population, while irregular or ectatic PVSs (status cribrosum) may be noted in 1–2 %. However, on standard imaging, slightly prominent PVSs are visible in 33 % of patients greater than or equal to 65 years of age.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Heier A, Bauer CJ, Schwartz L, Zimmerman RD, Morgello S, Deck MD. Large Virchow-Robin spaces: MR-clinical correlation. AJNR Am J Neuroradiol. 1989;10:929–36.
Gutierrez J, Rundek T, Ekind MS, Sacco RL, Wright CB. Perivascular spaces are associated with atherosclerosis: an insight from the Northern Manhattan Study. AJNR Am J Neuroradiol. 2013;34:1711–6.
Kwee RM, Kwee TC. Virchow-Robin spaces at MR imaging. Radiographics. 2007;27:1071–86.
Groeschel S, Chong WK, Surtees R, Hanefeld F. Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature. Neuroradiology. 2006;48:745–54.
Zhu YC, Dufouil C, Mazoyer B, Soumaré A, Ricolfi F, Tzourio C, Chabriat H. Frequency and location of dilated Virchow-Robin spaces in elderly people: a population-based 3D MR imaging study. AJNR Am J Neuroradiol. 2011;32:709–13.
Chen W, Song X, Zhang Y. Alzheimer’s disease neuroimaging initiative. Assessment of the Virchow-Robin spaces in Alzheimer disease, mild cognitive impairment, and normal aging using high-field MR imaging. AJNR Am J Neuroradiol. 2011;32:1490–5.
Suggested Reading
Bastos AC, Andermann F, Melancon D, Cendes F, Guberman A, Dubeau F, Olivier A. Late-onset temporal lobe epilepsy and dilatation of the hippocampal sulcus by an enlarged Virchow-Robin space. Neurology. 1998;50:784–7.
Bronen RA, Cheung G. MRI of the temporal lobe: normal variations, with special reference toward epilepsy. Magn Reson Imaging. 1991;9:501–7.
De Vita E, Thomas DL, Roberts S, Parkes HG, Turner R, Kinchesh P, et al. High resolution MRI of the brain at 4.7 Tesla using fast spin echo imaging. Br J Radiol. 2003;76:631–7.
Doubal FN, MacLullich AM, Ferguson KJ, Dennis MS, Wardlaw JM. Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease. Stroke. 2010;41:450–4.
Hervé D, Gautier-Bertrand M, Labreuche J, Amarenco P; GENIC Investigators. Predictive values of lacunar transient ischemic attacks. Stroke. 2004;35:1430–5.
Jungreis CA, Kanal E, Hirsch WL, Martinez AJ, Moossy J. Normal perivascular spaces mimicking lacunar infarction: MR imaging. Radiology. 1988;169:101–4.
Patankar TF, Mitra D, Varma A, Snowden J, Neary D, Jackson A. Dilatation of the Virchow-Robin space is a sensitive indicator of cerebral microvascular disease: study in elderly patients with dementia. AJNR Am J Neuroradiol. 2005;26:1512–20.
Pollock H, Hutchings M, Weller RO, Zhang ET. Perivascular spaces in the basal ganglia of the human brain: their relationship to lacunes. J Anat. 1997;191(Pt 3):337–46.
Salzman KL, Osborn AG, House P, Jinkins JR, Ditchfield A, Cooper JA, Weller RO. Giant tumefactive perivascular spaces. AJNR Am J Neuroradiol. 2005;26:298–305.
Sasaki M, Sone M, Ehara S, Tamakawa Y. Hippocampal sulcus remnant: potential cause of change in signal intensity in the hippocampus. Radiology. 1993;188:743–6.
Wuerfel J, Haertle M, Waiczies H, Tysiak E, Bechmann I, Wernecke KD, et al. Perivascular spaces—MRI marker of inflammatory activity in the brain? Brain. 2008;131(Pt 9):2332–40.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
McKinney, A.M. (2017). Dilated Perivascular Spaces. In: Atlas of Normal Imaging Variations of the Brain, Skull, and Craniocervical Vasculature . Springer, Cham. https://doi.org/10.1007/978-3-319-39790-0_14
Download citation
DOI: https://doi.org/10.1007/978-3-319-39790-0_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-39789-4
Online ISBN: 978-3-319-39790-0
eBook Packages: MedicineMedicine (R0)