Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) An erratum has been published Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Inglese, M. Articles by Rusinek, H. Search for Related Content PubMed PubMed Citation Articles by Inglese, M. Articles by Rusinek, H.

American Journal of Neuroradiology 26:719-724, April 2005
© 2005 American Society of Neuroradiology

BRAIN

Dilated Perivascular Spaces: Hallmarks of Mild Traumatic Brain Injury

Matilde Inglese^a, Elan Bomsztyk^a, Oded Gonen^a, Lois J. Mannon^a, Robert I. Grossman^a and Henry Rusinek^a

^a From the Department of Radiology, New York University School of Medicine, NY

Address reprint requests to Matilde Inglese, MD, PhD, Department of Radiology, New York University School of Medicine, 650 First Ave, New York, NY 10016

BACKGROUND AND PURPOSE: Recent animal and human studies have shown an increased frequency of enlarged, high-convexity Virchow-Robin spaces (VRS) in several neurologic diseases, suggesting their role as neuroradiologic markers of inflammatory changes. The aim of this study was to determine the prevalence of high-convexity dilated VRS in mild traumatic brain injury (TBI).

METHODS: T2-weighted, T1-weighted, fluid-attenuated inversion recovery, and T2*-weighted gradient-echo brain MR images were acquired in 24 patients with TBI (10 women, 14 men; mean age, 33.6; range, 18.1–50.8 years) and 17 age- and sex-matched healthy control subjects (nine women, eight men; mean age, 32.8; range, 18.4–47.8 years). The mean interval after TBI was 3.6 days (range, 1–9 days) in 15 patients and 3.7 years (range, 0.6–13.4 years) in nine patients. Axial T2-weighted images were used to identify dilated VRS and to measure CSF volume; T1-weighted images were used to measure brain volume. Dilated VRS were identified as punctuate areas with CSF-like signal intensity in the high-convexity white matter.

RESULTS: Mean (± standard deviation) number of VRS was significantly higher in patients (7.1 ± 4.6) than in controls (2.4 ± 2.9, P < .0003). In controls, VRS were associated with age (R = 0.69, P < .001) whereas in patients, they neither correlated with brain and CSF volumes nor with age and the elapsed time from injury.

CONCLUSION: Our results suggest that the increased number of dilated VRS is a radiologic marker of mild head injury that is readily detectable on T2-weighted images. Because their number does not vary with time from injury, VRS probably reflect early and permanent brain changes.

This article has been cited by other articles:

				M. F. Kraus, T. Susmaras, B. P. Caughlin, C. J. Walker, J. A. Sweeney, and D. M. Little White matter integrity and cognition in chronic traumatic brain injury: a diffusion tensor imaging study Brain, October 1, 2007; 130(10): 2508 - 2519. [Abstract] [Full Text] [PDF]

				R. M. Kwee and T. C. Kwee Virchow-Robin Spaces at MR Imaging RadioGraphics, July 1, 2007; 27(4): 1071 - 1086. [Abstract] [Full Text] [PDF]

				M. Castillo Whole-Brain N-Acetylaspartate: A Marker of the Severity of Mild Head Trauma AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 914 - 915. [Full Text] [PDF]