Variety in magnetic resonance imaging of enlarged perivascular space: Case reports

Abstract

Introduction: Expansion of perivascular spaces leads to tissue damage in the surrounding parenchyma. Enlarged perivascular spaces (EPS) have been long regarded as benign and normal variants, and have been subject to little investigation. We report three cases of EPS in unusual locations with their typical findings and clinical symptoms as consideration to differentiate them from other brain lesions. Case presentation: The first case was a 64-year-old woman presenting with vertigo, vomiting, and shoulder stiffness. The second case was a 25-year-old woman who worked as an agricultural trainee who complained of intermittent headaches 3 years before admission. The third case was a 42-year-old woman with dizziness and recurring headache. The MRI finding in T1 flair was a hypointense, which was surrounded by a hyperintensity wall. T2WI revealed a hyperintensity in the superior temporal lobe, with no pathological finding to prove an ischemic or infarction process in Diffuse Weighted Imaged (DWI) and Apparent Diffusion Coefficient (ADC) images. Conclusion: These 3 locations in our case reports should be one of consideration for diagnosing an EPS with its typical feature. A routine MRI study is needed to follow up progressivity of EPS.