Giant Virchow-Robin Spaces causing obstructive hydrocephalus

Case contributed by Dr Farhad Farzam


Chronic headache.

Patient Data

Age: 25 years
Gender: Male

Multiple, thin-wall, 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 resulting in obstructive hydrocephalus.

The dilated VR 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.

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Case information

rID: 68317
Published: 24th May 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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