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Neuropediatrics 2009; 40(5): 234-238
DOI: 10.1055/s-0029-1246158
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

Unilateral Dilation of Virchow-Robin Spaces in Early Childhood

K. Brockmann1 , S. Gröschel1 , S. Dreha-Kulaczewski1 , K. Reinhardt1 , J. Gärtner1 , P. Dechent2
  • 1Department of Pediatrics and Pediatric Neurology, Georg August University, Göttingen, Germany
  • 2MR-Research in Neurology and Psychiatry, Georg August University, Göttingen, Germany
Further Information

Publication History

received 13.05.2009

accepted 09.12.2009

Publication Date:
10 March 2010 (online)

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Abstract

Observations of extreme unilateral widening of Virchow-Robin spaces (VRS) are rare and hitherto confined to adult, mainly old-aged patients. Magnetic resonance imaging (MRI) was performed in two unrelated boys aged 3 years with developmental coordination disorders. In one of these patients, follow-up MRI and diffusion tensor imaging (DTI) were carried out 5 years later. In both boys, MRI incidentally revealed numerous intracerebral cysts strictly confined to one hemisphere. Localization, size, shape, and signal isointensity to cerebrospinal fluid indicated unilateral marked widening of VRS. In one patient, follow-up investigation after 5 years showed unchanged dilation of VRS on MRI, but mild facial hemihypertrophy, ipsilateral to the widened VRS. DTI indicated displacement rather than disruption of fiber tracks adjacent to the dilated VRS. Unilateral widening of VRS may be detected fortuitously on neuroimaging already in early childhood.

Key words

Virchow-Robin spaces - diffusion tensor imaging - facial hemihypertrophy

References

  • 1 Demaerel P, Wilms G, Baert AL. et al . Widening of Virchow-Robin spaces.  AJNR Am J Neuroradiol. 1996;  17 800-801
    PubMedGoogle Scholar
  • 2 Fumal A, de Noordhout AM, Collignon L. Neurological picture. Extreme unilateral widening of Virchow-Robin spaces mimicking stroke.  J Neurol Neurosurg Psychiatry. 2009;  80 64-65
    CrossrefPubMedGoogle Scholar
  • 3 Groeschel S, Chong WK, Surtees R. et al . Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature.  Neuroradiology. 2006;  48 745-754
    CrossrefPubMedGoogle Scholar
  • 4 Heier LA, Bauer CJ, Schwartz L. et al . Large Virchow-Robin spaces: MR-clinical correlation.  Am J Neuroradiol. 1989;  10 929-936
    PubMedGoogle Scholar
  • 5 Kamate M, Dumale A, Hattiholi V. Parenchymal brain cysts in Schimmelpenning-Feuerstein-Mims syndrome.  Neurol India.. 2009;  57 225-226
    PubMedGoogle Scholar
  • 6 Kwee RM, Kwee TC. Virchow-Robin spaces at MR imaging.  Radiographics. 2007;  27 1071-1086
    CrossrefPubMedGoogle Scholar
  • 7 Mathias J, Koessler L, Brissart H. et al . Giant cystic widening of Virchow-Robin spaces: an anatomofunctional study.  AJNR Am J Neuroradiol. 2007;  28 1523-1525
    CrossrefPubMedGoogle Scholar
  • 8 Neumann LM, Scheer I, Kunze J. et al . Cerebral manifestations, hemihypertrophy and lymphoedema of one leg in a child with epidermal nevus syndrome (Schimmelpenning-Feuerstein-Mims).  Pediatr Radiol. 2003;  33 637-640
    CrossrefPubMedGoogle Scholar
  • 9 Ogawa T, Okudera T, Fukasawa H. et al . Unusual widening of Virchow-Robin spaces: MR appearance.  Am J Neuroradiol. 1995;  16 1238-1242
    PubMedGoogle Scholar
  • 10 Owens T, Bechmann I, Engelhardt B. Perivascular spaces and the two steps to neuroinflammation.  J Neuropathol Exp Neurol. 2008;  67 1113-1121
    CrossrefPubMedGoogle Scholar
  • 11 Pavone L, Curatolo P, Rizzo R. et al . Epidermal nevus syndrome: a neurologic variant with hemimegalencephaly, gyral malformation, mental retardation, seizures, and facial hemihypertrophy.  Neurology. 1991;  41 266-271
    CrossrefPubMedGoogle Scholar
  • 12 Rieseberg S, Merboldt KD, Küntzel M. et al . Diffusion tensor imaging using partial Fourier STEAM MRI with projection onto convex subsets reconstruction.  Magn Reson Med. 2005;  54 486-490
    CrossrefPubMedGoogle Scholar
  • 13 Rollins NK, Deline C, Morriss MC. Prevalence and clinical significance of dilated Virchow-Robin spaces in childhood.  Radiology. 1993;  189 53-57
    PubMedGoogle Scholar
  • 14 Salzman KL, Osborn AG, House P. et al . Giant tumefactive perivascular spaces.  AJNR Am J Neuroradiol. 2005;  26 298-305
    PubMedGoogle Scholar
  • 15 Sawada M, Nishi S, Hashimoto N. Unilateral appearance of markedly dilated Virchow-Robin spaces.  Clin Radiol. 1999;  54 334-336
    CrossrefPubMedGoogle Scholar
  • 16 Shiratori K, Mrowka M, Toussaint A. et al . Extreme, unilateral widening of Virchow-Robin spaces: case report.  Neuroradiology. 2002;  44 990-992
    CrossrefPubMedGoogle Scholar
  • 17 Stephens T, Parmar H, Cornblath W. Giant tumefactive perivascular spaces.  J Neurol Sci. 2008;  266 171-173
    CrossrefPubMedGoogle Scholar
  • 18 Weller RO, Djuanda E, Yow HY. et al . Lymphatic drainage of the brain and the pathophysiology of neurological disease.  Acta Neuropathol. 2009;  117 1-14
    CrossrefPubMedGoogle Scholar
  • 19 Vles JS, Degraeuwe P, De Cock P. et al . Neuroradiological findings in Jadassohn nevus phakomatosis: a report of four cases.  Eur J Pediatr. 1985;  144 290-294
    CrossrefPubMedGoogle Scholar
  • 20 Zhang W, Simos PG, Ishibashi H. et al . Neuroimaging features of epidermal nevus syndrome.  AJNR Am J Neuroradiol. 2003;  24 1468-1470
    PubMedGoogle Scholar

Correspondence

Knut Brockmann

Department of Pediatrics and Pediatric Neurology

Georg August University

Robert Koch Straße 40

37075 Göttingen

Germany

Phone: +49/551/39-6210

Fax: +49/551/39-6252

Email: kbrock@med.uni-goettingen.de

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