Dilated Virchow-Robin spaces in children with seizures. A possible correlation?

Spalice, Alberto; Guido, Cristiana Alessia; Nicita, Francesco; Biasi, C. Di; Zicari, Anna Maria; Giannini, Luigi

doi:10.1016/j.mehy.2019.109481

Cited by 7 publications

(12 citation statements)

References 10 publications

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“…Regarding the shape of DPVS, in our study, most cases except for one had linear or ectatic shapes along the path of the penetrating arteries and arterioles. In terms of location, DPVS was observed either in basal ganglia, in supratentorial white matter, or in both locations, which is consistent with Spalice et al [24]. Therefore, we suggest that the perivascular space could potentially be related to the pain-inducing mechanism in children with headaches without other abnormal ndings.…”

Section: Discussionsupporting

confidence: 91%

“…Therefore, we suggest that the perivascular space could potentially be related to the pain-inducing mechanism in children with headaches without other abnormal ndings. DPVS has been reported with a frequency of 1.6% and 3% in healthy children and patients with various neurologic reasons, respectively [22][23][24]. Furthermore, we only included patients with headaches; therefore, it would also be meaningful to include a control group and compare the ndings of the perivascular space…”

Section: Discussionmentioning

confidence: 99%

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Dedicated neuroimaging in children with primary headache: prevalence of lesions and comparison between migraine and non-migraine

Jeon

Lim

Moon

2023

Preprint

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Purpose This study evaluated the prevalence and types of intracranial lesions through dedicated imaging analysis of primary headaches in children and compared them between migraine and non-migraine patients. Methods This study included 190 children diagnosed with primary headache who underwent neuroimaging, including brain computed tomography (CT), CT angiography (CTA), and brain magnetic resonance imaging (MRI). Patients were divided into two groups based on data from electronic medical records. Clinical characteristics and imaging findings were evaluated and compared between the two groups. Results Migraine patients were old and had a longer period from symptom onset to diagnosis. CT was normal in 71 of 95 patients, whereas 7 of 29 patients who underwent CTA had vascular lesions; the migraine group (n = 6/20, 30%) had higher incidence of vascular lesions than the non-migraine group (n = 1/9, 11.1%); however, there was no statistically significant difference (p = 0.382). Furthermore, 57.5% (61/106) of children showed normal brain MRI. The most common brain MRI finding was dilated perivascular space (n = 18, 16.8%). Most perivascular spaces were located in the basal ganglia (n = 72, 75.8%) and were in linear patterns (n = 58, 63.0%). There was no statistically significant difference between the two groups. Conclusion Low prevalence of significant abnormalities was found in children with primary headaches. Dilated perivascular space was the most common finding in both groups on MRI. CTA showed more vascular lesions in the migraine group than in the non-migraine group. Therefore, further evaluations are needed to reveal the relationship between vascular lesions or dilated perivascular space and pediatric primary headaches.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Dedicated neuroimaging in children with primary headache: prevalence of lesions and comparison between migraine and non-migraine

Jeon

Lim

Moon

2023

Preprint

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“…PVS have also been found to be enlarged in other brain diseases, implicating that the glymphatic system dysfunction may contribute to a wide variety of pathologies. 61 , 62 , 63 , 64 , 65 , 66 , 67 There have been multiple reports of enlarged PVS in pediatric populations of idiopathic generalized epilepsy. 63 , 64 , 66 , 67 Liu et al found that in children with newly diagnosed idiopathic generalized epilepsy, there were higher PVS number and volumes compared with healthy controls.…”

Section: Pvs In Diseasementioning

confidence: 99%

“… 61 , 62 , 63 , 64 , 65 , 66 , 67 There have been multiple reports of enlarged PVS in pediatric populations of idiopathic generalized epilepsy. 63 , 64 , 66 , 67 Liu et al found that in children with newly diagnosed idiopathic generalized epilepsy, there were higher PVS number and volumes compared with healthy controls. Additionally, they found a positive correlation between the seizure duration and the PVS burden and that after the seizure onset, the PVS burden gradually decreased with time.…”

Section: Pvs In Diseasementioning

confidence: 99%

Automated Methods for Detecting and Quantitation of Enlarged Perivascular spaces on MRI

Moses

Sinclair

Law

et al. 2022

Magnetic Resonance Imaging

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The brain's glymphatic system is a network of intracerebral vessels that function to remove “waste products” such as degraded proteins from the brain. It comprises of the vasculature, perivascular spaces (PVS), and astrocytes. Poor glymphatic function has been implicated in numerous diseases; however, its contribution is still unknown. Efforts have been made to image the glymphatic system to further assess its role in the pathogenesis of different diseases. Numerous imaging modalities have been utilized including two‐photon microscopy and contrast‐enhanced magnetic resonance imaging (MRI). However, these are associated with limitations for clinical use. PVS form a part of the glymphatic system and can be visualized on standard MRI sequences when enlarged. It is thought that PVS become enlarged secondary to poor glymphatic drainage of metabolites. Thus, quantitating PVS could be a good surrogate marker for glymphatic function. Numerous manual rating scales have been developed to measure the PVS number and size on MRI scans; however, these are associated with many limitations. Instead, automated methods have been created to measure PVS more accurately in different diseases. In this review, we discuss the imaging techniques currently available to visualize the glymphatic system as well as the automated methods currently available to measure PVS, and the strengths and limitations associated with each technique. Evidence Level 1 Technical Efficacy Stage 1

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“…ePVSs were counted visually in three different brain regions (supratentorial white matter, basal ganglia, and midbrain) and compared to a follow‐up MRI, taken at least 12 months from the initial MRI study. No significant correlation between a seizure onset zone (SOZ) and ePVSs or dynamic changes of PVSs on the follow‐up MRI was observed 61 …”

Section: Introductionmentioning

confidence: 99%

Role of the glymphatic system and perivascular spaces as a potential biomarker for post‐stroke epilepsy

Hlauschek,

Nicolo,

Sinclair

et al. 2023

Epilepsia Open

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Stroke is one of the most common causes of acquired epilepsy, which can also result in disability and increased mortality rates particularly in elderly patients. No preventive treatment for post‐stroke epilepsy is currently available. Development of such treatments has been greatly limited by the lack of biomarkers to reliably identify high‐risk patients. The glymphatic system, including perivascular spaces (PVS), is the brain's waste clearance system, and enlargement or asymmetry of PVS (ePVS) is hypothesized to play a significant role in the pathogenesis of several neurological conditions. In this article, we discuss potential mechanisms for the role of perivascular spaces in the development of post‐stroke epilepsy. Using advanced MR‐imaging techniques, it has been shown that there is asymmetry and impairment of glymphatic function in the setting of ischemic stroke. Furthermore, studies have described a dysfunction of PVS in patients with different focal and generalized epilepsy syndromes. It is thought that inflammatory processes involving PVS and the blood–brain barrier, impairment of waste clearance, and sustained hypertension affecting the glymphatic system during a seizure may play a crucial role in epileptogenesis post‐stroke. We hypothesize that impairment of the glymphatic system and asymmetry and dynamics of ePVS in the course of a stroke contribute to the development of PSE. Automated ePVS detection in stroke patients might thus assist in the identification of high‐risk patients for post‐stroke epilepsy trials.Plain Language SummaryStroke often leads to epilepsy and is one of the main causes of epilepsy in elderly patients, with no preventative treatment available. The brain’s waste removal system, called the glymphatic system which consists of perivascular spaces, may be involved. Enlargement or asymmetry of perivascular spaces could play a role in this and can be visualised with advanced brain imaging after a stroke. Detecting enlarged perivascular spaces in stroke patients could help identify those at risk for post‐stroke epilepsy.

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Dilated Virchow-Robin spaces in children with seizures. A possible correlation?

Cited by 7 publications

References 10 publications

Dedicated neuroimaging in children with primary headache: prevalence of lesions and comparison between migraine and non-migraine

Dedicated neuroimaging in children with primary headache: prevalence of lesions and comparison between migraine and non-migraine

Automated Methods for Detecting and Quantitation of Enlarged Perivascular spaces on MRI

Role of the glymphatic system and perivascular spaces as a potential biomarker for post‐stroke epilepsy

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