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Klinische Bedeutung normaler und erweiterter Virchow-Robin-Räume

Clinical relevance of normal and enlarged Virchow-Robin spaces

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Zusammenfassung

Virchow-Robin-Räume umgeben die penetrierenden Gefäße des Gehirnparenchyms. Sie kommunizieren mit dem subpialen Raum, sind gefüllt mit interstitieller Flüssigkeit und beheimaten eine spezifische Population von Makrophagen.

Virchow-Robin-Räume sind häufig in der CT- und MRT-Bildgebung sichtbar. Neuere radiologische Untersuchungen haben zu einer bildlichen Charakterisierung und Abgrenzung des normalen vom erweiterten Virchow-Robin-Raum geführt. Virchow-Robin-Räume erscheinen in allen Bildgebungssequenzen liquorisointens und treten an folgenden Prädilektionsstellen auf: in den Basalganglien, subkortikal im Marklager oder im Mittelhirn und Pons. Erweiterte Virchow-Robin-Räume können einzeln oder multipel auftreten. In seltenen Fällen verursachen sie einen Hydrozephalus. Einige Studien weisen auf ein gehäuftes Auftreten erweiterter Virchow-Robin-Räume bei älteren Patienten, bei arterieller Hypertonie und bei CADASIL hin.

In diesem Übersichtsartikel stellen wir die diagnostischen Merkmale normaler und pathologischer Virchow-Robin-Räume dar und diskutieren deren klinische Bedeutung. Ferner geben wir einen Überblick über den derzeitigen Kenntnisstand zur Anatomie, Physiologie und Pathologie der Virchow-Robin-Räume.

Summary

Virchow-Robin spaces ensheathe the penetrating vessels of the brain. They communicate with the subpial space, are filled with interstitial fluid and contain a specific population of macrophages.

Virchow-Robin spaces are a common finding in both CT and MR imaging. Recent radiologic studies have led to a concise definition of Virchow-Robin spaces.

Virchow-Robin spaces appear isointense to cerebrospinal fluid on all imaging sequences. They are typically localised in the basal ganglia, subcortically or in the midbrain and pons. Enlarged Virchow-Robin spaces may appear as a single or multiple lesion(s). They may cause hydrocephalus in rare cases. Some studies indicate that enlarged Virchow-Robin spaces occur more frequently in elderly patients, in patients with arterial hypertension or CADASIL.

In this review we illustrate the diagnostic criteria of normal and enlarged Virchow-Robin spaces and discuss their clinical relevance. Furthermore, we present an overview of the current knowledge on the anatomy, physiology and pathology of Virchow-Robin spaces.

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Authors and Affiliations

  1. Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Straße 33, 48149, Münster, Deutschland

    B. Gess MD, E.B. Ringelstein & W.R. Schäbitz

  2. Institut für klinische Radiologie, Universitätsklinikum Münster, Münster, Deutschland

    T.U. Niederstadt

  3. Neurologische Klinik, Evangelisches Krankenhaus Bielefeld, Bielefeld, Deutschland

    W.R. Schäbitz

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  1. B. Gess MD
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  2. T.U. Niederstadt
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  3. E.B. Ringelstein
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  4. W.R. Schäbitz
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Correspondence to B. Gess MD.

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Gess, B., Niederstadt, T., Ringelstein, E. et al. Klinische Bedeutung normaler und erweiterter Virchow-Robin-Räume. Nervenarzt 81, 727–733 (2010). https://doi.org/10.1007/s00115-010-2983-y

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  • DOI: https://doi.org/10.1007/s00115-010-2983-y

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