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Neuroendoscopic treatment of symptomatic giant Virchow–Robin spaces

Smith, Kyle
; 
Lavin, Paul
; 
Chamoun, Roukoz
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Abstract
Background: Virchow-Robin spaces (VRS) or perivascular spaces are interstitial cystic spaces surrounding the vasculature of brain parenchyma and course from the subarachnoid space. Small VRS (less than 2 mm) appear in all age groups, but can enlarge and be confused with other lesions like cystic neoplasms. These enlarged VRS are termed giant tumefactive perivascular spaces (GRPVS). Case Description: We present the case of a 50-year-old male who presents with right eye pain, blurred vision, headache, and gait imbalance. He was diagnosed with GRPVS and underwent an endoscopic third ventriculostomy and cyst fenestration. Postoperative imaging showed a decrease in size of the ventricular system with evidence of flow through the aqueduct and ventriculostomy. Brainstem VRS cysts decreased in size. Conclusion: Unlike the other small number of case reports, this patient is unique in his age of presentation and successful endoscopic method of treatment. The endoscopic approach provided great exposure and adequate access to the lesions. Clinically, symptoms improved, cyst size decreased, and need for permanent shunt placement was averted.
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A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.
Date
2015-07-20
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Medknow Publications
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KU Scholarly Papers Funded by the KU Open Access Fund
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Keywords
Cyst fenestration, Endoscopy, Neuroendoscopy, Virchow-Robin spaces
Citation
Smith KA, Lavin P, Chamoun R. Neuroendoscopic treatment of symptomatic giant Virchow–Robin spaces. Surg Neurol Int 20-Jul-2015;6:120
URI
https://hdl.handle.net/1808/30757
DOI
10.4103/2152-7806.161240
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