From the Research
A large right perivascular space in the right basal ganglia on a CT scan of the brain is generally considered a normal anatomical variant and not a pathological finding. These spaces, also called Virchow-Robin spaces, are extensions of the subarachnoid space that follow blood vessels as they penetrate brain tissue. No specific treatment is needed for perivascular spaces as they are benign findings. They appear as well-defined, round or linear areas that follow the path of blood vessels, with fluid density similar to cerebrospinal fluid on CT scans.
While enlarged perivascular spaces are common and typically asymptomatic, they are more prevalent with aging and can be associated with conditions like hypertension or cerebral small vessel disease, as shown in a study published in the Journal of cerebral blood flow and metabolism 1. This study found that enlarged perivascular spaces in the basal ganglia are associated with arteries, not veins.
Some key points to consider include:
- Enlarged perivascular spaces are a marker of cerebral small vessel disease (SVD) and have been identified as a marker of dysfunctional brain clearance, as discussed in a study published in Neurology 2.
- The association between enlarged perivascular spaces and atherosclerosis has been explored, and a study published in Atherosclerosis found that enlarged basal ganglia perivascular spaces are independently associated with intracranial atherosclerosis in the elderly 3.
- Enlarged perivascular spaces in the basal ganglia have been linked to cognitive function in patients with cerebral small vessel disease, as shown in a study published in Current neurovascular research 4.
If you have symptoms like headaches, cognitive changes, or neurological deficits, these are likely unrelated to the perivascular space and should be evaluated separately. Regular follow-up with your healthcare provider is recommended if you have other risk factors for cerebrovascular disease, but the perivascular space itself does not require intervention or monitoring, as per the discussion in Nature reviews. Neurology 5.