Tumefactive Virchow Robin Spaces and its Mimics in Paediatric Patients: A Pictorial Review
Bhavini Gupta1*, Sumit Pruthi2, Omprakash Tavri1 and Sarfaraz Shaikh1
1Department of Radiology, Dr. D.Y. Patil University School of Medicine, India
2Vanderbilt Children’s Hospital, Nashville, Tennessee, USA
*Corresponding Author: Bhavini Gupta, Department of Radiology, Dr. D.Y. Patil University School of Medicine, India.
April 14, 2021; Published: May 20, 2021
Virchow Robin spaces represent pial-lined perivascular spaces and correspond to extensions of subarachnoid space, found in certain characteristic locations around the brain. These spaces are predominantly filled with interstitial fluid and follow CSF intensity on imaging. Enlarged Virchow-Robin spaces, also known as enlarged perivascular spaces (EPVS) are considered when their size increases beyond 2 mm.
EPVS can have varied appearance and may appear in varying locations, making diagnosis difficult. They may be found in normal young individuals, in the mesencephalon, hippocampus and basal ganglia regions, but are usually associated with lower cognition in the healthy older population. Among the younger patients, EPVS are associated with inflammatory and metabolic disorders. While EPVS is common, it is generally overlooked due to their uncertain pathophysiology.
The current review aims to evaluate and characterize different pathologies associated with enlarged and prominent Virchow-Robin spaces and demonstrate the uncommon presentations of common entities that mimic prominent VR spaces. Due to the lack of clinical data, a large proportion of the cases presented in this study are misdiagnosed as some of their commoner counterparts, limning the need to outline characteristic features of these diseases. This will help to tailor treatment appropriately and help the patients who suffer from these disorders.
Presenting cases of enlarged bilateral tumefactive VR spaces were studied retrospectively, including their biochemical, genetic, and clinical features, to finally arrive at a diagnosis.
Keywords: Tumefactive VR Spaces; Virchow-Robin Spaces; Neuroradiology; Periventricular Cysts
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