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IMAGE IN NEUROLOGY
Year : 2015  |  Volume : 18  |  Issue : 4  |  Page : 454
 

Giant perivascular space in the anterior superior temporal gyrus: Imaging characteristics to avoid misdiagnosis


Department of Medical Imaging, Gold Coast University Hospital, Gold Coast, Queensland, Australia

Date of Submission30-May-2015
Date of Decision22-Jun-2015
Date of Acceptance23-Jun-2015
Date of Web Publication17-Nov-2015

Correspondence Address:
Charlie Chia-Tsong Hsu
Department of Medical Imaging, Gold Coast University Hospital, Gold Coast, Queensland - 4215
Australia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.169647

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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 Oct 21];18:454. Available from: http://www.annalsofian.org/text.asp?2015/18/4/454/169647



   Clinical Case Top


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. [1],[2] 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 [1],[2] Temporal stability is necessary to confirm its benign nature and avoid unnecessary intervention.

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Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
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.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    


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