The Virchow-Robin spaces: delineation by magnetic resonance imaging with considerations on anatomofunctional implications

• Published in: Child's nervous system Vol. 27; no. 12; pp. 2057 - 2066
• Main Authors: Tsutsumi, Satoshi, Ito, Masanori, Yasumoto, Yukimasa, Tabuchi, Takashi, Ogino, Ikuko
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.12.2011
• Subjects: Adolescent; Adult; Aged; Brain - pathology; Child; Child, Preschool; Craniocerebral Trauma - pathology; Dilatation, Pathologic - pathology; Female; Humans; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosciences; Neurosurgery; Original Paper; Prospective Studies; Subarachnoid Space - anatomy & histology; Subarachnoid Space - pathology; Young Adult; Physiological function; Anatomy; Dilated Virchow-Robin spaces; Virchow-Robin spaces
• ISSN: 0256-7040; 1433-0350; 1433-0350
• DOI: 10.1007/s00381-011-1574-y

Introduction The Virchow-Robin spaces (V-R spaces) are well-known, but not systematically understood fluid-filled perivascular spaces that allow the convexity and basal perforating vessels to penetrate deep into the cerebral parenchyma. Objective This study aims to delineate anatomical characteristics of the normal V-R spaces by MR imaging with considerations on clinical and anatomofunctional implications of the V-R spaces. Methods In this prospective study with 3T magnetic resonance (MR) imaging, the whole extent of the intracranial V-R spaces was classified into basal, cortical, subcortical, paraventricular, and brainstem segments, on the basis of the topological difference in 105 control subjects. Morphological characteristics in each segment of the V-R spaces are described. For comparison with the neuroimaging appearance, V-R spaces were histologically examined in cadaveric human brains. The physiological functions of the V-R spaces and pathognomonic implications of unusually dilated, but asymptomatic, V-R spaces encountered in five subjects are discussed. Results The V-R spaces were found to form a complicated, while anatomically highly consistent, intraparenchymal canal network distributed over the whole cerebral hemispheres and connect the cerebral convexity, basal cistern, and ventricular system. Conclusion The V-R spaces may be essential for drainage routes of cerebral metabolites, additional buoyancy for the brain, and maintenance of homogenous intracranial pressure. MR imaging may be more advantageous in depicting the V-R spaces than histological examination.