Presentation
Chronic headache
Patient Data
Multiple thin-walled cystic spaces predominantly in the left basal ganglia and left thalamus showing isointense signal relative to CSF on all pulse sequences without post contrast enhancement nor perifocal edema. The lesions are exerting mass effect over the third ventricle with consequent moderate dilatation of the lateral ventricles.
Case Discussion
Dilated Virchow-Robin spaces rarely cause mass effect and result in obstructive hydrocephalus.
The dilated bit how-to in spaces follow CSF signal on all MR sequences without signal changes in the surrounding brain parenchyma nor solid enhancing components which allow certain diagnosis.
The differential diagnosis for giant VR spaces are cystic neoplasms which rarely follow CSF signal and cystic periventricular leukomalacia.