Cognitive impairment due to widespread enlarged perivascular spaces
Perivascular spaces, also known as Virchow-Robin spaces, are usually considered as a normal, asymptomatic finding. However, this finding can occasionally demonstrate an atypical appearance and can be symptomatic. We report herein a rare case of cognitive impairment associated with extremely enlarged...
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doaj-202a1fd477f54fe491de2c093d8947eb2021-07-31T04:38:35ZengElsevierRadiology Case Reports1930-04332021-09-0116926402645Cognitive impairment due to widespread enlarged perivascular spacesYoshitaka Yamaguchi, MDPhD0Manabu Wada, MDPhD1Luna Kimihira, MDPhD2Hikaru Nagasawa, MDPhD3Corresponding author. .; Department of Neurology, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata 990-2292, JapanDepartment of Neurology, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata 990-2292, JapanDepartment of Neurology, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata 990-2292, JapanDepartment of Neurology, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata 990-2292, JapanPerivascular spaces, also known as Virchow-Robin spaces, are usually considered as a normal, asymptomatic finding. However, this finding can occasionally demonstrate an atypical appearance and can be symptomatic. We report herein a rare case of cognitive impairment associated with extremely enlarged perivascular spaces. A 68-year-old Japanese woman visited our hospital with a 1-year history of progressive memory impairment. In addition to temporal disorientation and short-term memory impairment, neuropsychological testing showed frontal lobe-related symptoms such as slowed thinking processes, reduced verbal fluency, attention deficit, and reduced working memory. Magnetic resonance imaging of the brain showed widespread enlarged perivascular spaces almost symmetrically in the subcortical white matter of bilateral hemispheres, prominently in bilateral insulas, and frontal opercula. On 99mTc-ethyl cysteinate dimer single photon emission computed tomography, hypoperfusion was apparent in bilateral insulas and frontal opercula where enlarged periventricular spaces were prominent, whereas cerebral perfusion was preserved in areas where enlargement of perivascular spaces was mild or absent. Because symptoms were consistent with the distribution of the enlarged perivascular spaces and hypoperfusion in the brain, cognitive impairment due to enlarged perivascular spaces was diagnosed. Clinicians should note enlarged perivascular spaces as a potential cause of neurological deficits including cognitive impairment.http://www.sciencedirect.com/science/article/pii/S1930043321004179Cognitive impairmentMagnetic resonance imagingPerivascular spaceSingle photon emission computed tomographyVirchow-Robin space |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yoshitaka Yamaguchi, MDPhD Manabu Wada, MDPhD Luna Kimihira, MDPhD Hikaru Nagasawa, MDPhD |
spellingShingle |
Yoshitaka Yamaguchi, MDPhD Manabu Wada, MDPhD Luna Kimihira, MDPhD Hikaru Nagasawa, MDPhD Cognitive impairment due to widespread enlarged perivascular spaces Radiology Case Reports Cognitive impairment Magnetic resonance imaging Perivascular space Single photon emission computed tomography Virchow-Robin space |
author_facet |
Yoshitaka Yamaguchi, MDPhD Manabu Wada, MDPhD Luna Kimihira, MDPhD Hikaru Nagasawa, MDPhD |
author_sort |
Yoshitaka Yamaguchi, MDPhD |
title |
Cognitive impairment due to widespread enlarged perivascular spaces |
title_short |
Cognitive impairment due to widespread enlarged perivascular spaces |
title_full |
Cognitive impairment due to widespread enlarged perivascular spaces |
title_fullStr |
Cognitive impairment due to widespread enlarged perivascular spaces |
title_full_unstemmed |
Cognitive impairment due to widespread enlarged perivascular spaces |
title_sort |
cognitive impairment due to widespread enlarged perivascular spaces |
publisher |
Elsevier |
series |
Radiology Case Reports |
issn |
1930-0433 |
publishDate |
2021-09-01 |
description |
Perivascular spaces, also known as Virchow-Robin spaces, are usually considered as a normal, asymptomatic finding. However, this finding can occasionally demonstrate an atypical appearance and can be symptomatic. We report herein a rare case of cognitive impairment associated with extremely enlarged perivascular spaces. A 68-year-old Japanese woman visited our hospital with a 1-year history of progressive memory impairment. In addition to temporal disorientation and short-term memory impairment, neuropsychological testing showed frontal lobe-related symptoms such as slowed thinking processes, reduced verbal fluency, attention deficit, and reduced working memory. Magnetic resonance imaging of the brain showed widespread enlarged perivascular spaces almost symmetrically in the subcortical white matter of bilateral hemispheres, prominently in bilateral insulas, and frontal opercula. On 99mTc-ethyl cysteinate dimer single photon emission computed tomography, hypoperfusion was apparent in bilateral insulas and frontal opercula where enlarged periventricular spaces were prominent, whereas cerebral perfusion was preserved in areas where enlargement of perivascular spaces was mild or absent. Because symptoms were consistent with the distribution of the enlarged perivascular spaces and hypoperfusion in the brain, cognitive impairment due to enlarged perivascular spaces was diagnosed. Clinicians should note enlarged perivascular spaces as a potential cause of neurological deficits including cognitive impairment. |
topic |
Cognitive impairment Magnetic resonance imaging Perivascular space Single photon emission computed tomography Virchow-Robin space |
url |
http://www.sciencedirect.com/science/article/pii/S1930043321004179 |
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