IMAGE IN NEUROLOGY
|Year : 2015 | Volume
| Issue : 4 | Page : 454
Giant perivascular space in the anterior superior temporal gyrus: Imaging characteristics to avoid misdiagnosis
Charlie Chia-Tsong Hsu, Dalveer Singh, Gigi Nga Chi Kwan, Sandeep Bhuta
Department of Medical Imaging, Gold Coast University Hospital, Gold Coast, Queensland, Australia
|Date of Submission||30-May-2015|
|Date of Decision||22-Jun-2015|
|Date of Acceptance||23-Jun-2015|
|Date of Web Publication||17-Nov-2015|
Charlie Chia-Tsong Hsu
Department of Medical Imaging, Gold Coast University Hospital, Gold Coast, Queensland - 4215
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Hsu CC, Singh D, Kwan GN, Bhuta S. Giant perivascular space in the anterior superior temporal gyrus: Imaging characteristics to avoid misdiagnosis. Ann Indian Acad Neurol 2015;18:454
|How to cite this URL:|
Hsu CC, Singh D, Kwan GN, Bhuta S. Giant perivascular space in the anterior superior temporal gyrus: Imaging characteristics to avoid misdiagnosis. Ann Indian Acad Neurol [serial online] 2015 [cited 2019 Jul 20];18:454. Available from: http://www.annalsofian.org/text.asp?2015/18/4/454/169647
| Clinical Case|| |
A 36-year-old female with migraine underwent magnetic resonance imaging (MRI) brain evaluation. An incidental subcortical cystic lesion was detected in the right anterior superior temporal gyrus [Figure 1]. Follow-up MRI confirmed stability over 3 years.
|Figure 1: Magnetic resonance imaging (MRI) revealed a T2 hyperintense (a) subcortical cystic lesion (arrow) in the right anterior superior temporal gyrus inferior to the middle cerebral artery (arrow head). It is of cerebrospinal fluid signal intensity (suppressed on fluid-attenuated inversion recovery (FLAIR), b) and showed minor perilesional edema but no gadolinium enhancement was seen (c and d). FLAIR = Fluid-attenuated inversion recovery|
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Giant perivascular spaces (PVS) may mimic cortically-based neoplasm such as dysembryoplastic neuroepithelial tumor. The recently recognized location in the anterior superior temporal gyrus adjacent to the middle cerebral artery is an important diagnostic clue. , Giant PVS follow cerebrospinal fluid signal on all MRI sequences and do not demonstrate contrast enhancement; however, variable perilesional edema is observed, which may relate to adjacent gliosis or several adjacent tiny PVS , Temporal stability is necessary to confirm its benign nature and avoid unnecessary intervention.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Rawal S, Croul SE, Willinsky RA, Tymianski M, Krings T. Subcortical cystic lesions within the anterior superior temporal gyrus: A newly recognized characteristic location for dilated perivascular spaces. AJNR Am J Neuroradiol 2014;35:317-22.
Lim AT, Chandra RV, Trost NM, McKelvie PA, Stuckey SL. Large anterior temporal Virchow-Robin spaces: Unique MR imaging features. Neuroradiology 2015;57:491-9.