multiple cystic lesions in white matter without clinical manifestations (unidentified black holes)

  • L. A. Bacheschi
  • A. C. A. Magalhães
  • S. C. Mathias


We report three patients with normal daily life and normal professional or school activities who were submitted for cerebral MRI studies owing to minor symptoms. MRI showed multiple and wide lesions in one or both hemispheres which were iso-intense relative to cerebrospinal fluid on all pulse sequences. No convincing clinical or laboratory evidence was found to explain the exact nature of these lesions. The possibility of dilated Virchow-Robin spaces (VRS) seems too simplistic because of the size and shape, specifically of the unilateral lesions, which are not usual characteristics of VRS.

key words

Virchow-Robin spaces Brain abnormalities Magnetic resonance imaging 


  1. 1.
    Rollins NK, Deline C, Morriss MC (1993) Prevalence and clinical significance of dilated Virchow-Robin spaces in childhood. Radiology 189:53–75.PubMedGoogle Scholar
  2. 2.
    When SM, Heins ER, Burgen PC, Boyko OB (1989) Dilated Virchow-Robin spaces in cryptococcal meningitis associated with AIDS: CT and MR findings: J Comput Assist Tomogr 13:756–762.CrossRefGoogle Scholar
  3. 3.
    Braffman BH, Zimmerman RA, Trojanowiski JQ, Gonatas NK, Hickey WS, Schlaepfer WW (1988) Brain MR: pathologic correlation with gross and histopathology. 1. Lacunar infarction and Virchow-Robin spaces. AJR 151:551–558.PubMedCrossRefGoogle Scholar
  4. 4.
    Jungreis CA, Kanal E, Hirsch WL, Martinez AJ, Moossy J (1988) Normal perivascular spaces mimicking lacunar infarction: MR imaging. Radiology 169:101–104.PubMedGoogle Scholar
  5. 5.
    Heir LA, Bauer CJ, Schwartz L, Zimmerman RT, Morgello S, Deck MD (1989) Large Virchow-Robin spaces: MR-clinical correlation. AJNR 10:929–936.Google Scholar
  6. 6.
    Esiri MM, Gay D (1990) Immunological and neuropathological significance of the Virchow-Robin space. J Neurol Sci 100:3–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Yetkin FZ, Hanghton VM, Fischer ME, Papke RA, Daniels DL, Mark LP, Hendrix LE, Asleson RJ, Johansen J (1992) High-signal foci on MR images of the brain: observer variability in their quantification. AJR 159:185–188.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • L. A. Bacheschi
    • 1
  • A. C. A. Magalhães
    • 1
  • S. C. Mathias
    • 1
  1. 1.Department of Radiology, Section of Magnetic Resonance, Hospital das ClinicasUniversity of São PauloSão PauloBrazil

Personalised recommendations