Tumefactive perivascular spaces

Case contributed by Abdulmajid Bawazeer
Diagnosis almost certain

Presentation

Head trauma. No loss of consciousness.

Patient Data

Age: 20 years
Gender: Male
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Axial T2
fat sat
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1
This study is a stack
Coronal
T2
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
Gradient Echo
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Info

Intraparenchymal multiloculated cystic lesion of CSF intensity in the left basal ganglia extending to the left temporal lobe with minimal surrounding FLAIR hyperintensity. No restriction diffusion, enhancement or mass effect.

The lenticulostriate artery passes through the multiloculated cyst.

Case Discussion

Virchow-Robin spaces or perivascular spaces are small pial lined, cystic structures in the brain and are filled with interstitial fluid. They are normal spaces, identified in all age groups and are common in places where the penetrating vessels enter into the substance of the brain. Occasionally, these spaces can be enlarged and are termed as giant tumefactive perivascular spaces.1

It is important to recognize these to avoid unnecessary biopsy and potentially devastating complications. 

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