Dilated Virchow-Robin spaces: MRI pathological study

Abstract

We performed a histopathological study of two human brains to look at dilated Virchow-Robin (V-R) spaces in the anterior perforated substance and putamen. We measured the diameter of 74 arteries in 54 dilated V-R spaces. In 28 patients without neurological deficits we ascertained the characteristic location of dilated V-R spaces in the anterior perforated substance and basal ganglia on MRI, measuring the distance from 64 foci of cerebrospinal fluid signal intensity to the centre of the mamillary body on 1 mm thick images. In the histopathological study, the mean diameter of the arteries was 39.0 +/- 36.0 microns. Dilatation of the V-R space was observed from the end of the indentation of the pial membrane towards the brain surface along the perforating artery. In the MR images, the mean distance from the dilated V-R space to the mamillary body was 10.0 +/- 4.5 mm. The V-R space was confined to a fixed level in the lower part of the basal ganglia, and not found near the brain surface.

Subcortical Cystic Lesions within the Anterior Superior Temporal Gyrus: A Newly Recognized Characteristic Location for Dilated Perivascular Spaces

“…2 Dilated perivascular spaces are benign expansions of these normal structures, typically located at the inferior basal ganglia along the anterior commissure. 3 Giant perivascular spaces, measuring 1.5 cm, most commonly occur within the mesencephalothalamic region, where they may manifest with obstructive hydrocephalus. 1 Although less common, these lesions have been reported to exist focally else- where in the brain parenchyma, including the subcortical white matter.…”

Assessment of the Virchow-Robin Spaces in Alzheimer Disease, Mild Cognitive Impairment, and Normal Aging, Using High-Field MR Imaging

“…[5][6][7][8][9] Several mechanisms may underlie the neuropathologic enlargement of VRS, including increased permeability of the arterial wall, brain atrophy and tissue fibrosis, perivascular demyelination, and obstruction of lymphatic drainage pathways and/or CSF circulation. 3,10 VRSs have been identified as a biomarker indicative of microvascular disease and are strongly related to systemic vascular disease; a possible association of VRS with vascular risk factors has been proposed. 5,[11][12][13] Many vascular risk factors are also risk factors for AD 14,15 so vascular and degenerative mechanisms are considered to have parallel effects.…”

Dilatação dos espaços de Virchow-Robin em pacientes com migrânea

“…Ou, ainda, em achados ocasionais em pacientes sem anormalidades fisiológicas 11,12 , presumivelmente variantes do normal. Schick e cols., consideram variantes anatômicas os EVR amplos quando adjacentes à comissura anterior e tronco encefálico 14 .…”

“…Estudos com microscopia eletrôni-ca, sugerem que os EVR originam-se de invaginações do espaço subpial, formando uma bainha de revestimento que contém as artérias separando o espaço subaracnóide do subpial 3,4 .A dilatação dos EVR é facilmente detectada pela ressonância magnética (RM) 5 e tem sido descrita em pacientes com criptococose 6 , mucopolissacaridose 7 , crianças com cefaléia 8 , envelhecimento 9 macrocefalia e epilepsia do lobo temporal 10 ou ainda, em achados ocasionais concebidos como variantes do normal 11,12 .Nós revimos 70 RM de pacientes com migrânea e comparamos com igual número de pacientes sem antecedentes de cefaléia. RESUMO -Os espaços de Virchow-Robin (EVR) são invaginações do espaço subpial, formando uma bainha de revestimento tubular contendo um vaso, que separa o espaço subaracnóide do subpial.…”

“…A dilatação dos EVR é facilmente detectada pela ressonância magnética (RM) 5 e tem sido descrita em pacientes com criptococose 6 , mucopolissacaridose 7 , crianças com cefaléia 8 , envelhecimento 9 macrocefalia e epilepsia do lobo temporal 10 ou ainda, em achados ocasionais concebidos como variantes do normal 11,12 .…”