Presentation
Incidental finding. No symptoms.
Patient Data
There is a cystic appearing lesion in the white matter of the left parietal lobe with lobulated margins and thin internal septations. The internal signal characteristics are those of CSF and there is no abnormal enhancement post administration of contrast.
Impression:
Benign appearing cystic lesion in the left parietal white matter. A very vascular space is favored but follow-up imaging is suggested to ensure that this is not a progressive abnormality.
A number of MRI scans were performed over the years, all demonstrating unaltered appearances of left parietal cystic lesion.
Case Discussion
Perivascular spaces, when in atypical locations, can be concerning and lead to extended periods of follow-up. Once stability is established the only real differential is that of a neuroglial/neuroepithelial cyst. Septations and elongation along the expected perimedullary vessels favor a perivascular space.