[Importance of Virchow-Robin spaces]

Abstract

Virchow-Robin spaces are perivascular fluid-filled cavities that surround perforating arteries and veins in the brain parenchyma. As a rule in healthy people they are approximately 5 mm in diameter. Typical localizations are brainstem ganglia, mesencephalon and the white matter of the brain. Morphological imaging characteristics of Virchow-Robin spaces are round or tubular, smoothly bordered areas which are hyperintense in T2-weighted sequences. Virchow-Robin spaces represent a physiological structure in normal brain parenchyma. It is assumed that they contain interstitial fluid filled with macrophages and play an important role in the drainage of interstitial fluid in the direction of the cervical lymph system. In many diseases, such as Alzheimer's disease, cerebrovascular diseases and traumatic brain injuries, an association with Virchow-Robin spaces is assumed. In the differential diagnostics lacunar infarcts, cystic space-occupying lesions, low-grade malignant tumors and arachnoid cysts must be considered. In individual studies an association with frequently occurring expanded perivascular spaces in patients with arterial hypertension and patients with CADASIL disease was established. Rarely, Virchow-Robin spaces are so expanded that they lead to compression of the aqueduct or the foramina of Monro with subsequent hydrocephalus.

Keywords: Brain parenchyma; Interstitial fluid; Intracerebral vascular system; Lymph vessels; Perivascular spaces.