Perivascular spaces

Case contributed by A.Prof Frank Gaillard

Presentation

Asymptomatic.

Patient Data

Age: 15 years
Gender: Female
MRI

Within the medial aspect of the right frontal lobe, in the white matter at the corticomedullary Junction, is a line of small septated cystic spaces, isointense to CSF on all imaging sequences, apart from one small area of gliosis is shown on the flair sequence, 5 mm in size. There is no positive mass effect, no haemosiderin staining, diffusion restriction, or abnormal contrast enhancement. Intracranial arteries appear normal, and there is no evidence of arteriovenous malformation. Ventricles and sulci are otherwise age-appropriate in normal.

CONCLUSION: 

The cystic lesions in the right frontal lobe are considered likely to represent a developmental anomaly, and almost certainly represent clusters of dilated Virchow Robin spaces (perivascular spaces). The lack of a solid or enhancing component and the macro cystic nature would be most unusual for DNET or any low grade glial tumour. 

Case Discussion

This abnormality was found incidentally, and has remained completely unchanged over 7 years. The features are characteristic of perivascular spaces, albeit in a slightly unusual location. They should not be mistaken for tumours or acute pathology. 

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Case information

rID: 43388
Case created: 8th Mar 2016
Last edited: 18th Mar 2016
Inclusion in quiz mode: Included

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