Dilated Virchow-Robin spaces - idiopathic

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Impaired cognitive ability and memory.

Patient Data

Age: 80 years
Gender: Male

MRI Brain

mri

Dilated perivascular spaces at the basal ganglia particularly on the left (base of the brain corresponding to perforating arteries) that follow CSF signal in all pulse sequences giving the appearance of etat crible. Also, there are multiple lacunar infarcts at the corona radiata and centrum semiovale bilaterally that display bright signal in T2 and FLAIR.

Case Discussion

Differential diagnosis in this case:

  • dilated perivascular space
  • lacunar infarcts. 

They are distinguished by the location and the signal intensity in FLAIR which gives the lacunar infarcts bright signal due to the presence of gliosis.

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