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General Neurology and Rare Disorders Discussions about general neurology and undiagnosed conditions, including rare disorders that may not be separately listed.

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Old 05-07-2007, 12:47 PM
sarahin sarahin is offline
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Question Dilated perivascular spaces in the basal ganglia

Hi,
I had a MRI due to a brain aneursym which also showed that I have dilated perivascular spaces in the basal ganglia. Has anyone else had this experience in this or know of any good web sites on the subject? Thanks.
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Old 05-17-2007, 11:36 AM
pkinohio pkinohio is offline
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Cool

Hi-
I am new to the site, I am searching too. I have also been recently diagnosed with dilated perivascular spaces in the basal ganglia and also a venous angioma. I have been suffering with severe headaches and dizziness for quite a while and an MRI was done. My neuro does not seem to think it's serious or that it is causing my headaches but I am searching for answers. Please let me know if you find out anything and I will do the same. God Bless
PK
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Old 05-19-2007, 05:09 PM
Lara Lara is offline
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My son who is on the autism spectrum has dilated Virchow-Robin Spaces. If you're looking for something specific, try using the key search words in a search engine or in Medscape or in PubMed.

My impression is that doctors and scientists are not sure just what their significance is in general yet. I have seen certain connections in some of my reading but other reading suggests "normal varients" so I can't really offer too much.

Here are just a couple of things I'd saved a long time ago in my bookmarks. With newer imaging techniques developed in the past few years, there may be much more available to research than when I was looking years ago.

http://spinwarp.ucsd.edu/NeuroWeb/Text/br-840vr.htm
Heier LA, Bauer CJ, Schwartz L, et al: Large Virchow-Robin spaces: MR-clinical correlation. AJNR10:929-936, 1989.
NOTE: this one is very old.

Quote:
Virchow-Robin Perivascular Spaces

When nutrient vessels penetrate the brain substance, the pia mater is carried along with the vessel down to the capillary level. The small subarachnoid space that follows the pia is called the Virchow-Robin (VR) space. These perivascular CSF spaces appear as punctate areas of high signal on T2-weighted images.

Occasionally, very large (1 cm or more) VR spaces will be observed in the basal ganglia region. If the patient is young and has no risk factors for vascular or degenerative disease, these large VR spaces are probably normal variants, representing a confluence of penetrating arteries and veins.

Not infrequently, VR spaces in the brainstem will be sufficiently large to be seen on MR images. On T2-weighted axial images they are sectioned longitudinally and appear as hyperintense linear structures coursing in a ventrolateral direction. Their linear character generally distinguishes them from small brainstem infarcts.

If the brain become atrophic and loses volume, it retracts away from the vessels and extracellular fluid fills the space. On postmortem studies, these perivascular fluid spaces appear like a network of tunnels within the brain substance. These changes have been termed état criblé (sieve-like). These fluid spaces simply represent dilated VR spaces. Brain atrophy results in dilated VR spaces in the same manner that the cortical sulci become enlarged. As expected, in older patients with atrophic brains the VR spaces are larger and appear more numerous
http://www.jcat.org/pt/re/jcat/abstr...856144!8091!-1
Accentuated Virchow-Robin Spaces in the Centrum Semiovale in Children With Autistic Disorder.
Neuroimaging
Journal of Computer Assisted Tomography. 28(2):263-268, March/April 2004.
Taber, Katherine H PHD; Shaw, J Bryant MS; Loveland, Katherine A PHD; Pearson, Deborah A PHD; Lane, David M PHD; Hayman, L Anne MD
Quote:
Conclusion: Unusually large VR spaces are seen in at most 22% to 27% of MR scans in children with tension headaches and other psychiatric disorders, suggesting that the incidence of spaces of this type is greater in AD than in other abnormal populations. The origin and significance of this phenomenon remain unknown.
I have a few more but they're more specific to children.

Edited to add: you could search in some of the Journals.
e.g. Journal of Neurosurgery
http://www.thejns-net.org/jns/issues/current/toc.html

Here's the link to PubMed.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed

Medscape
http://www.medscape.com/home

Last edited by Lara; 05-19-2007 at 05:32 PM.
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Old 05-21-2007, 01:54 AM
pkinohio pkinohio is offline
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From what I've found, "dilated perivascular spaces" are also knowns as Virchow-Robin spaces.

Try http://en.wikipedia.org/wiki/Virchow-Robin_spaces. The description is still somewhat cryptic, but it at least tells you what it is. The bigger issue is whether this is a problem or is "normal" in some people.

The abstract found at http://www.ajnr.org/cgi/content/abstract/10/5/929 tries to answer this question, but the conclusion I see is that, at least in this study, perivascular dilation is most closely correlated with age and not much else.
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Old 05-22-2007, 06:59 PM
sarahin sarahin is offline
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Thanks for the info. It's appreciated.
Sarah
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