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Giant Tumefactive Perivascular Spaces

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 8 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR
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Child with headache.

Case Images


Giant Tumefactive Perivascular Spaces


MR – Non-enhancing smoothly marginated ovoid lesions isointense to cerebrospinal fluid in the left cerebral subcortical white matter


Perivascular spaces (Virchow-Robin spaces) are pial lined interstitial spaces that accompany penetrating arteries. Blockage of interstitial drainage, increased CSF pulsations, increased arterial permeability, and abnormal deposition (amyloid, mucopolysaccharide, etc). Perivascular spaces may become quite large and amorphous. Typically enlarged perivascular spaces occur along the lenticulostriate arteries near the anterior commissure and less commonly in the subinsular region, cerebral subcortical white matter and dentate nuclei. Large perivascular spaces may have significant mass effect and adjacent gliosis. Differential considerations include cystic neoplasms, parasitic cysts, cystic leukomalacia, neuroepithelial cysts, ventricular diverticula and deposition disorders.


Salzman KL, Osborn AG, House P, et al. Giant Tumefactive Perivascular Spaces. Am J Neuroradiol (2005);26:298-305.

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