Enlarging Perivascular Spaces Following Radiation Therapy in the Brain: A Report of Two Cases and Literature Review.

Enlarging Perivascular Spaces Following Radiation Therapy in the Brain: A Report of Two Cases and Literature Review.:

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Enlarging Perivascular Spaces Following Radiation Therapy in the Brain: A Report of Two Cases and Literature Review.

World Neurosurg. 2020 Apr 03;:

Authors: Mark IT, Carr CM, Ruff MW, Flanagan EP, Johnson DR

Abstract

BACKGROUND: Virchow-Robin or enlarged perivascular spaces (PVS) are benign pial-lined spaces that surround penetrating arteries and arterioles through the brain parenchyma. We present two cases of enlarging perivascular spaces following whole brain radiation therapy in adults.

CASE DESCRIPTION: We observed two cases of enlarging PVS occurring following whole brain radiation therapy for adult onset medulloblastoma. Neither patient had an enlarged PVS at the time of radiation treatment. They presented in the basal ganglia six and eight years following the completion of radiation, respectively, one of which subsequently decreased in size over time. Neither patient had symptoms, required surgical intervention, or had signs of tumor recurrence.

CONCLUSIONS: Enlarging PVS can occur years after radiation therapy to the brain parenchyma. The recognition of these benign perivascular spaces is important so as not to mistake the changes for more sinister pathology that could lead to unnecessary intervention. This observation also suggests that focal cystic changes more frequently seen surrounding areas of focal brain radiation therapy may represent enlarged PVS.

PMID: 32251809 [PubMed - as supplied by publisher]