Atypical Virchow-Robin SpacesMimicking Cystic Primary Brain Tumor ­ Clinical Report and Literature Review

The Virchow-Robin spaces (VRSs), which are often incidentally observed in modern structural neuroimaging examinations, are small cystic cavities that usually surround the small arteries and arterioles at the level of basal ganglia, the anterior perforated substance and the thalamic-mesencephalic junction. Typically, they have similar physicochemical characteristics to cerebral spinal fluid (CSF) and there is no contrast enhancement on brain CT andMRI images. Its real meaning is unknown, although some contemporary studies have suggested that it might be related to certain traumatic brain injury or several other central nervous system (CNS) disorders, as degenerative diseases. Occasionally, some wide and atypical VRS may be mistaken for primary cystic brain tumors, especially in the context of large and symptomatic lesions, multiple clustered cysts, cortical lesions and if there is adjacent reactive gliosis. The present paper reports four patients who were affected by atypical VRS mimicking brain tumors that required imaging follow-up or even a biopsy to confirm the diagnosis or to indicate the correct approach. Although it is not so unusual, one of them occurred concomitantly and adjacent to a diffuse glioma (co-deleted 1p19q, WHO-GII).

Analysis of the factors influencing expansion of Virchow-Robin spaces in basal ganglia and central semiovale / 中国医师进修杂志

Objective To investigate the factors influencing expansion of Virchow-Robin spaces (VRS) in basal ganglia and central semiovale.Methods One hundred and ninety-six patients with acute single lacunar infarction were analyzed retrospectively from June 2015 to June 2019 in Fukuang General Hospital of Liaoning Health Industry Group (Seventh Clinical College of China Medical University).Among them,108 patients with basal ganglia infarction and 88 patients with central semiovale infarction were included.MRI was used to evaluate the extent of VRS expansion.Univariate analysis and multivariable Logistic regression analysis were used to analyze the related factors affecting VRS expansion in basal ganglia and central semiovah.Results Univariate analysis showed that there were significant differences in the female,proportion of hypertension,systolic blood pressure and body mass index (BMI) between the mild enlarged group (48 cases) and the severe enlarged group (148 cases) of VRS expansion in basal ganglia:22 cases vs.40 cases,35.4％(17/48) vs.78.4％(116/148),(138.7 ± 14.2)mmHg (1 mmHg=0.133 kPa) vs.(150.3 ± 12.0) mmHg and (26.7 ± 2.5) kg/m2 vs.(24.1 ± 2.2) kg/m2,and there were statistical differences (P＜0.05 or ＜0.01);and there were significant differences in the proportion of hypertension,diabetes mellitus and BMI between the mild enlarged group (79 cases) and the severe enlarged group (117 cases) of VRS expansion in central semiovale (P＜0.05).Multivariable Logistic regression analysis showed that hypertension (OR=6.383,95％ CI 1.942 to 18.204,P=0.005),BMI (OR=0.768,95％ CI 0.620 to 0.938,P=0.010) significantly affected the expansion of VRS expansion in basal ganglia,while BMI significantly affected the expansion of VRS expansion in central semiovale (OR=0.784,95％ CI 0.642 to 0.921,P=0.003).Conclusions Hypertension is the independent risk factor of VRS expansion in basal ganglia,and BMI is the protective factor of VRS expansion in basal ganglia and central semiovale.

A Case of Meningioma in Temporo-occipital Lobe without Dural Attachment in a 14-yer-old Girl: Case Report

Meningiomas are thought to arise from the arachnoid cap or meningothelial cells. This frequent apposition to the dura mater probably accounts for the usual attachment of the neoplasm to this layer. We report a case of intraparenchymal meningioma without dural attachment in a 14-year-old girl. A survey of the literature reveals that the majority of cases of meningiomas without dural attachment occur either in children or below the tentorium, and most of them located in the ventricle, the cranial vault. Intraparenchymal meningioma without dural attachment, however, are extremely rare. The uncommon locations of meningiomas at sites distant from the duramater is believed to reflect the rare occurrence of arachnoid cap cells in the Virchow-Robin spaces along the cerebral vasculature or in the pial layers distant from the dura mater.

Unusual widening of Virchow-Robin spaces (report of 1 case) / 临床神经病学杂志

Objective To investigate the reasons of the unusual widening of Virchow-Robin spaces (VRS) and its clinical significance. Methods Clinic and MRI data of 1 case of VRS were analyzed retrospectively and related literatures were reviewed. Results VRS usually existed in the healthy adults and widening with age. In this case, VRS was a benign anatomic variant without special clinical significance. But in children, unusual widening of VRS suggested clinical significance. Conclusions Widening of VRS has no clear relation to clinical symptoms for adults. However, it is helpful in differentiation of diseases.