Virchow-Robin spaces

Virchow-Robin spaces, or enlarged perivascular spaces (EPVS) are spaces (often only potential) that surround blood vessels for a short distance as they enter the brain. Their wall is formed by prolongations of the pia mater.

Function

They contain macrophages and lymphocytes and have been suggested to be the site of entry for these cells of the immune system to the CSF.

The spaces function as pathways for the drainage of interstitial fluid, are in direct connection with the subpial space, are separated by a single layer of pia mater from the subarachnoid space and are in communication with lymphatic channels of the head and neck, leading to cervical lymph nodes.

Appearance

Virchow-Robin spaces appear as punctate or linear hypointensities, isointense with cerebrospinal fluid on T2-weighted images, oin the centrum semiovale, basal ganglia, and the hippocampus.

Clinical significance

These spaces are mostly seen in cryptococcal meningoencephalitis caused by a fungus. While in some people they may be both numerous and widespread throughout the brain and like white matter lesions, Virchow-Robin spaces are not usually present in the brains of healthy young adults. The presence of Virchow-Robin has been associated with multiple diseases.

This space is involved in Perivascular Cuffing seen in meningoencephalitis & encephalitis where there are infiltrates of mononuclear cells.

Eponym

Virchow-Robin spaces are also called His’ perivascular spaces and perivascular spaces. They are named after Rudolf Virchow and Charles-Philippe Robin (French anatomist, 1821–1885).
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