Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

  1. Akter M, Hirai T, Kitajima M, Yamada K, Hayashida Y, Okuda T, Takeshima H, Kuratsu J, Yamashita Y (2007) Multiple prominent dilated perivascular spaces do not induce Wallerian degeneration as evaluated by diffusion tensor imaging. AJNR Am J Neuroradiol 28:283–284

    PubMed  CAS  Google Scholar 

  2. Algin O, Hakyemez B, Parlak M (2010) Phase-contrast MRI and 3D-CISS versus contrast-enhanced MR cisternography on the evaluation of the aqueductal stenosis. Neuroradiology 52:99–108

    Article  PubMed  Google Scholar 

  3. Blow N (2007) Tissue preparation: tissue issues. Nature 448:959–963, Small vessel disease: a population-based study. Stroke 41: 2483–2490

    Article  PubMed  Google Scholar 

  4. Bruna AL, Martins I, Husson B, Landrieu P (2009) Developmental dilatation of Virchow-Robin spaces: a genetic disorder? Pediatr Neurol 41:275–280

    Article  PubMed  Google Scholar 

  5. Caner B, Bekar A, Hakyemez B, Taskapilioglu O, Aksoy K (2008) Dilatation of Virchow-Robin perivascular spaces: report of 3 cases with different localizations. Minim Invasive Neurosurg 51:11–14

    Article  PubMed  CAS  Google Scholar 

  6. Cerase A, Vallone IM, Muccio CF, Petrini C, Signori G, Venturi C (2010) Regression of dilated perivascular spaces of the brain. Surg Radiol Anat 32:555–561

    Article  PubMed  Google Scholar 

  7. Doubal FN, MacLullich AM, Ferguson KJ, Dennis MS, Wardlaw JM (2010) Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease. Stroke 41:450–454

    Article  PubMed  Google Scholar 

  8. Dziewiatkowski J, Spondnik J, Wójcik S, Spondnik E, Moryś J (2002) The influence of storage time upon the real thickness of the histological brain sections. Folia Histochem 40(2):115–116

    CAS  Google Scholar 

  9. Etemadifar M, Hekmatnia A, Tayari N, Kazemi M, Ghazevi A, Akbari M, Maghzi AH (2010) Features of Virchow-Robin spaces in newly diagnosed multiple sclerosis patients. Eur J Radiol Jul 20 (in press)

  10. Fayeye O, Pettorini BL, Foster K, Rodrigues D (2010) Mesencephalic enlarged Virchow-Robin spaces in a 6-year-old boy: a case-based update. Childs Nerv Syst 26:1155–1160

    Article  PubMed  Google Scholar 

  11. Flors L, Levina-Salinas C, Cabrera G, Mazón M, Poyatos C (2010) Obstructive hydrocephalus due to cavernous dilation of Virchow-Robin spaces. Neurology 74:1746

    Article  PubMed  CAS  Google Scholar 

  12. Frýdl V, Koch R, Závodská H (1989) The effect of formalin fixation on several properties of the brain. Zentralbl Allg Pathol 135:649–655, Article in German

    PubMed  Google Scholar 

  13. Grinberg LT, Amaro E Jr, Teipel S, dos Santos DD, Pasqualucci CA, Leite RE, Camargo CR, Gonçalves JA, Sanches AG, Santana M, Ferretti RE, Jacob-Filho W, Nitrini R, Heinsen H; Brazilian Aging Brain Study Group (2008) Assessment of factors that confound MRI and neuropathological correlation of human postmortem brain tissue. Cell Tissue Bank 9:195–203

    Article  Google Scholar 

  14. Groeschel S, Chong WK, Surtees R, Hanefeld F (2006) Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature. Neuroradiology 48:745–754

    Article  PubMed  Google Scholar 

  15. House P, Salzman KL, Osborn AG, MacDonald JD, Jensen RL, Couldwell WT (2004) Surgical considerations regarding giant dilations of the perivascular spaces. J Neurosurg 100:820–824

    Article  PubMed  Google Scholar 

  16. Hunziker O, Schweizer A (1977) Postmortem changes in stereological parameters of cerebral capillaries. Beitr Pathol 161:244–255

    PubMed  CAS  Google Scholar 

  17. Kida S, Steart PV, Zhang ET, Weller RO (1993) Perivascular cells act as scavengers in the cerebral perivascular spaces and remain distinct from pericytes, microglia and macrophages. Acta Neuropathol 85:646–652

    Article  PubMed  CAS  Google Scholar 

  18. Komiyama M, Yasui T, Izumi T (1998) Magnetic resonance imaging features of unusually dilated Virchow-Robin spaces—two case reports. Neurol Med Chir Tokyo 38:161–164

    Article  PubMed  CAS  Google Scholar 

  19. Kwee RM, Kwee TG (2007) Virchow-Robin spaces at MR imaging. Radiographics 27:1071–1086

    Article  PubMed  Google Scholar 

  20. Marinkovic S, Gibo H, Filipović B, Đulejić V, Piščević I (2005) Microanatomy of the subependymal arteries of the lateral ventricle. Surg Neurol 63:451–458

    Article  PubMed  Google Scholar 

  21. Mathias J, Koessler L, Brissart H, Foscolo S, Schmitt E, Bracard S, Braun M, Kremer S (2007) Giant cystic widening of Virchow-Robin spaces: an anatomofunctional study. AJNR Am J Neuroradiol 28:1523–1525

    Article  PubMed  CAS  Google Scholar 

  22. Ogawa T, Okudera T, Fukasawa H, Hashimoto M, Inugami A, Fujita H, Hatazawa J, Shimosegawa E, Noguchi K, Uemura K, Nakajima S, Yasui N (1995) Unusual widening of Virchow-Robin spaces: MR appearance. AJNR Am J Neuroradiol 16:1238–1242

    PubMed  CAS  Google Scholar 

  23. Papayannis CE, Saidon P, Rugilo CA, Hess D, Rodriguez G, Sica RE, Rey RC (2003) Expanding Virchow Robin spaces in the midbrain causing hydrocephalus. AJNR Am J Neuroradiol 24:1399–1403

    PubMed  Google Scholar 

  24. Rennels ML, Gregory TF, Blaumanis OR, Fujimoto K, Grady PA (1985) Evidence for a ‘paravascular’ fluid circulation in the mammalian central nervous system, provided by the rapid distribution of tracer protein throughout the brain from the subarachnoid space. Brain Res 326:47–63

    Article  PubMed  CAS  Google Scholar 

  25. Sadowski M, Moryś J, Berdel B, Maciejewska B (1995) Influence of fixation and histological procedure on the morphometric parameters of neuronal cells. Folia Morphol Warsz 54:219–226

    PubMed  CAS  Google Scholar 

  26. Sheth S, Branstetter BF 4th, Escott EJ (2009) Appearance of normal cranial nerves on steady-state free precession MR images. Radiographics 29:1045–1055

    Article  PubMed  Google Scholar 

  27. Shiratori K, Mrowka M, Toussaint A, Spalke G, Bien S (2002) Extreme, unilateral widening of Virchow-Robin spaces: case report. Neuroradiology 44:990–992

    Article  PubMed  CAS  Google Scholar 

  28. Tomita N, Kodama F, Kanamori H, Motomura S, Ishigatsubo Y (2002) Prophylactic intrathecal methotrexate and hydrocortisone reduces central nervous system recurrence and improves survival in aggressive non-Hodgkin lymphoma. Cancer 95:576–580

    Article  PubMed  CAS  Google Scholar 

  29. Ugawa Y, Shirouzu I, Terao Y, Hanajima R, Machii K, Mochizuki H, Furubayashi T, Kanazawa I (1998) Physiological analyses of a patient with extreme widening of Virchow-Robin spaces. J Neurol Sci 159:25–27

    Article  PubMed  CAS  Google Scholar 

  30. Wuerfel J, Haertle M, Waiczies H, Tysiak E, Bechmann I, Wernecke KD, Zipp F, Paul F (2008) Perivascular spaces—MRI marker of inflammatory activity in the brain? Brain 131:2332–2340

    Article  PubMed  Google Scholar 

  31. Zhang ET, Inman CB, Weller RO (1990) Interrelationships of the pia mater and the perivascular (Virchow-Robin) spaces in the human cerebrum. J Anat 170:111–123

    PubMed  CAS  Google Scholar 

  32. Zhu YC, Dufouil C, Soumaré A, Chabriat H, Tzourio C (2010) High degree of dilated Virchow-Robin spaces on MRI is associated with increased risk of dementia. J Alzheimers Dis 22:663–672

    PubMed  Google Scholar 

  33. Zhu YC, Tzourio C, Soumaré A, Mazoyer B, Dufouil C, Chabriat H (2010) Severity of dilated Virchow-Robin spaces is associated with age, blood pressure, and MRI markers of small vessel disease: a population-based study. Stroke 41:2483–2490

    Article  PubMed  Google Scholar 

  34. Zhu YC, Dufouil C, Mazoyer B, Soumaré A, Ricolfi F, Tzourio C, Chabriat H (2011) Frequency and location of dilated virchow-robin spaces in elderly people: a population-based 3D MR imaging study. AJNR Am J Neuroradiol 32:709–713

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was not supported by any grants.

Conflict of interest statement

The authors declare no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Author information

Authors and Affiliations

  1. Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan

    Satoshi Tsutsumi, Masanori Ito & Yukimasa Yasumoto

  2. Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan

    Takashi Tabuchi

  3. Department of Neurological Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Ikuko Ogino

Authors
  1. Satoshi Tsutsumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masanori Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yukimasa Yasumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takashi Tabuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ikuko Ogino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Satoshi Tsutsumi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tsutsumi, S., Ito, M., Yasumoto, Y. et al. The Virchow-Robin spaces: delineation by magnetic resonance imaging with considerations on anatomofunctional implications. Childs Nerv Syst 27, 2057–2066 (2011). https://doi.org/10.1007/s00381-011-1574-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-011-1574-y

Keywords

Search

Navigation