J Clin Neurol.  2007 Jun;3(2):96-100. 10.3988/jcn.2007.3.2.96.

A Case of Disseminated Polycystic Dilated Perivascular Spaces Presenting with Dementia and Parkinsonism

• Kim DG
• Oh SH
• Kim OJ

• KMID: 1851020
• DOI: http://doi.org/10.3988/jcn.2007.3.2.96

Abstract

The perivascular spaces (PVSs) of the brain are lined with pia and contain interstitial fluid. In general, PVSs are small, asymptomatic, and identifiable at all ages. When PVSs are significantly enlarged, they can produce various clinical manifestations such as headache and dizziness. A 67-year-old man was admitted with cognitive impairment and gait disturbance with a 5-month history. Brain MRI showed multiple cystic PVSs in periventricular and subcortical white matter of both hemispheres. Medication with dopaminergic agents produced a moderate clinical improvement, while anticholinesterase was not effective. This case suggests that disseminated polycystic dilated PVSs may present with dementia and Parkinsonism.

Keyword

Perivascular space; Dementia; Parkinsonism

MeSH Terms

Aged
Brain
Dementia*
Dizziness
Dopamine Agents
Extracellular Fluid
Gait
Headache
Humans
Magnetic Resonance Imaging
Parkinsonian Disorders*
Dopamine Agents

Figure

• 

  Figure 1 Clusters of variable-sized CSF-intensity cysts with minimal surrounding gliosis and expansion of overlying gyri were present in periventricular white matter and subcortical areas of both frontoparietal, left temporal, and left occipital lobes. Clusters of variable-sized cysts showed a high signal intensity on T2-weighted images (A, B) and a low signal intensity on fluid-attenuated inversion-recovery images (C, D).

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