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¹Sher-I-Kashmir Institute of Medical Sciences, Deparatment of Radiodiagnosis & Imaging, Srinagar, India
²Sher-I-Kashmir Institute of Medical Sciences, Department of Pathology, Srinagar, India DOI : 10.5137/1019-5149.JTN.2848-09.0 Perivascular spaces surround the small arteries and veins as they enter into the brain parenchyma from the subarachnoid spaces. Also called as Virchow-Robin spaces, these are prominent in the basal ganglia and high convexity white matter of the elderly. Occasionally VR spaces may get massively enlarged and may mimic a cystic mass lesion. The typical CSF-like signal intensity of the cysts and location on MRI, in the absence of a neurological abnormality help in the diagnosis of the giant VR spaces and thus biopsy is avoided. Typically there is no significant adjacent brain abnormality; however FLAIR images may sometimes reveal perilesional white matter hyperintensity, which may be an indication of gliosis due to the mass effect of the lesion. Such a signal alteration should not deter one from making a diagnosis of giant Virchow-Robin spaces when the rest of the imaging findings are typical. We describe a case of a 50-year-old female with incidental giant Virchow-Robin spaces in the right hemispheric subcortical white matter with adjacent white matter hyperintense signal intensity on T2-weighted and FLAIR images. Keywords : Fluid attenuation inversion recovery (FLAIR) sequence, MRI, Virchow-Robbin spaces