Giant tumefactive perivascular spaces: A further case

Virchow-Robin spaces (VRS) or the perivascular spaces are small pial lined, cystic structures in the brain and are filled with interstitial fluid. They are normal spaces, identified in all age groups and are common in places where the penetrating vessels enter into the substance of brain. Occasionally, these spaces can be enlarged and are termed as giant tumefactive perivascular spaces (GTPVS). When enlarged, these cysts are commonly confused with other lesions such as cystic neoplasms. The pathognomonic imaging appearance helps in the diagnosis of this condition in most instances and invasive management is unwarranted. We report a 4-year-old male with GTPVS. In our patient, GTPVS were diagnosed incidentally on brain imaging ordered for a head trauma and he was managed conservatively. During 1-year follow-up, he remained asymptomatic and the size of the cysts was virtually unchanged.