Rouhl R P W, van Oostenbrugge R J, Knottnerus I L H, Staals J E A, Lodder J
Dept. of Neurology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
J Neurol. 2008 May;255(5):692-6. doi: 10.1007/s00415-008-0777-y. Epub 2008 Feb 21.
Virchow-Robin spaces (VRs) are perivascular spaces surrounding the deep perforating brain arteries. VRs dilatation is pathologic, and it could be a manifestation of cerebral small vessel disease. In the present study we assessed the relation between VRs and silent ischemic lesions in a cohort of patients with cerebral small vessel disease.
We divided dilated VRs on MRI (1.5 Tesla) into three semi-quantitative categories in 165 first ever lacunar stroke patients. We counted asymptomatic lacunar infarcts and graded white matter lesions, and compared the prevalence of vascular risk factors in different categories of VRs. We also determined independent predictors of silent ischemic lesions.
VRs at basal ganglia level related to age, hypertension, asymptomatic lacunar infarcts, and white matter lesions. VRs at basal ganglia level predicted silent ischemic lesions (odds ratio 10.58 per higher VRs category; 95 %- confidence interval 3.40 - 32.92).
Dilated VRs in the basal ganglia relate to the severity of cerebral small vessel disease and might be a manifestation of the same small vessel abnormality that causes silent ischemic lesions. This adds a role for VRs as a potential marker for small vessel disease.
血管周围间隙（VRs）是围绕脑深部穿支动脉的血管周围间隙。VRs扩张是病理性的，可能是脑小血管病的一种表现。在本研究中，我们评估了一组脑小血管病患者中VRs与无症状缺血性病变之间的关系。
我们将165例首次发生腔隙性卒中患者的MRI（1.5特斯拉）上扩张的VRs分为三个半定量类别。我们对无症状腔隙性梗死进行计数并对脑白质病变进行分级，并比较不同类别VRs中血管危险因素的患病率。我们还确定了无症状缺血性病变的独立预测因素。
基底节水平的VRs与年龄、高血压、无症状腔隙性梗死和脑白质病变有关。基底节水平的VRs可预测无症状缺血性病变（每增加一个VRs类别，比值比为10.58；95%置信区间为3.40 - 32.92）。
基底节中扩张的VRs与脑小血管病的严重程度有关，可能是导致无症状缺血性病变的同一小血管异常的一种表现。这增加了VRs作为小血管病潜在标志物的作用。
