Giant Perivascular Spaces
Last Updated: October 1, 2018
- Pia-lined interstitial fluid filled spaces
- Do not communicate with subarachnoid space
- Fluid accumulation causing cystic-appearing spaces
- Almost always normal, though patients may have headache
- May have association with small vessel disease and hemorrhage
- No age predilection
- M > F
- Variably-sized fluid-filled spaces with the signal of CSF
- Round or even linear hypodense lesions with similar characteristics to CSF
- Multiple well-delineated small cysts isointense to CSF
- May have cumulative focal mass effect, particularly if involving the basal ganglia
- Isointense to CSF without surrounding edema
- Normal diffusivity
- No enhancement
- MR with contrast
- DWI can be helpful
- May mimic infection, lacunar infarct or even cystic tumor. Location is often a key to the correct diagnosis, but MRI may help by demonstrating identical signal intensity to normal CSF and a lack of surrounding gliosis or enhancement.
For more information, please see the corresponding chapter in Radiopaedia.
Contributor: Sean Dodson, MD
Eluvathingal Muttikkal TJ, et al. Spontaneous regression and recurrence of a tumefactive perivascular space. Neuroradiol J. 2014; 27(2):195-202.
John S, et al. Tumefactive perivascular spaces mimicking cerebral edema in a patient with diabetic hyperglycemia hyperosmolar syndrome: a case report. Journal of Medical Case Reports. 2013; 7:51. 10.1186/1752-1947-7-51.
Salzman KL, et al. Giant Tumefactive Perivascular Spaces. AJNR. 2005; 26: 298-305.
Stephens T, et al. Giant Tumefactive Perivascular Spaces. J Neurol Sci. 2008; 266(1-2):171-3.
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