If a brain pathology is suspected, patients are prescribed magnetic resonance imaging. Often, the results of the study indicate that the patient has expanded perivascular spaces. How dangerous is it? And what diseases can indicate such a sign? We will consider these issues in the article.
What is this
Perivascular spaces are located between the walls of blood vessels and the white matter of the brain. These formations are also called criblures or Virchow-Robin spaces. They are filled with CSF and regulate the outflow of cerebrospinal fluid.
Normally, criblures are so small that they are not visible on an MRI. However, there are cases when the examination determines the expanded perivascular spaces. What does this diagnostic result mean? This suggests that criblures are visualized during an MRI examination. They look like spots of white in the picture.
Reasons
Dilated perivascular spacesRobin - Virchow are not always a sign of pathology. This result of the diagnosis is also observed in quite he althy people. Most often, the expansion of criblures is observed in elderly patients and is associated with age-related changes in the brain.
However, in some cases, enlarged perivascular spaces may be a sign of the following diseases and conditions:
- cerebral atrophy;
- leukoareosis;
- cerebral ischemia (including cerebral infarction);
- disseminated encephalomyelitis.
In elderly people, the expansion of cribs is often noted with hypertension, atherosclerosis, dementia. These pathologies are usually accompanied by memory impairment and other cognitive impairments.
Additional diagnostic methods
What to do if the MRI results indicate that you have enlarged perivascular Virchow-Robin spaces? It is necessary to show the transcript of the study to the neurologist. Only a specialist can determine whether this is a variant of the norm, an age-related feature, or a sign of pathology.
There are cases when MRI does not reveal any changes in the brain, but the picture shows the enlarged perivascular Virchow-Robin spaces. What does this mean? As a rule, such a symptom does not indicate pathology. Doctors consider an increase in criblures only in combination with other changes detected during an MRI examination.
If necessary, the doctor may prescribe additional tests:
- multispiral computed tomography;
- vascular angiography;
- doppler;
- liquor research.
Let's take a closer look at the most common diseases and conditions that can lead to Kriblure expansion.
Brain atrophy
If a patient has enlarged perivascular spaces and at the same time the volume of the brain is reduced, then doctors talk about atrophy of the organ. Most often it is a sign of the following diseases:
- senile dementia;
- atherosclerosis;
- Alzheimer's disease.
In these diseases, the death of neurons occurs. This is accompanied by memory impairment, mental impairment, mental disorders. Typically, such diseases occur in elderly patients.
In some cases, expanded perivascular spaces of Virchow - Robin are determined in newborns. This may be a sign of serious genetic diseases, accompanied by the death of neurons.
How to treat such pathologies? After all, it is no longer possible to restore the lost neurons. You can only slow down the process of dying of nerve cells. Patients are prescribed the following drugs for symptomatic therapy:
- nootropics: Piracetam, Cavinton, Nootropil;
- sedatives: Phenazepam, Phenibut;
- antidepressants: Valdoxan,"Amitriptyline".
The prognosis of such pathologies is usually unfavorable, as brain atrophy and neuronal death progress.
Leukoareosis
Leukoareosis doctors call rarefaction of the white matter of the brain. Due to structural changes in the nervous tissue, patients have expanded perivascular spaces. This is also a sign of diseases common to older people:
- hypertension;
- atherosclerosis;
- senile dementia.
Changes in the white matter of the brain cause cognitive impairment. Patients receive symptomatic treatment with nootropic drugs. These drugs improve the nutrition of neurons and stop their death. With atherosclerosis, statins are indicated. Antihypertensive drugs are prescribed for high blood pressure.
Ischemic conditions
When ischemia worsens the blood supply to the brain. This is usually the result of atherosclerotic changes in the vessels. The patient periodically experiences dizziness, double vision, coordination disorders, speech and memory disorders. Due to changes in the vessels, the spaces around their walls also expand.
Patients are prescribed nootropic drugs ("Piracetam", "Cerebrolysin", "Actovegin"), as well as drugs that normalize metabolism in brain cells ("Cortexin", "Ceraxon"). At the same time, it is very important toetiotropic treatment of atherosclerosis with statins. Prescribe drugs "Lovastatin", "Atorvastatin", "Simvastatin". This therapy eliminates the cause of ischemia.
Cerebral infarction
Often, perivascular spaces are enlarged in patients who have had a cerebral infarction. This disease is a consequence of prolonged ischemia. In some cases, cerebral infarction is asymptomatic and goes unnoticed by the patient. Its effects can only be seen on an MRI scan.
It is important to remember that if a patient has risk factors (high blood pressure, atherosclerosis, diabetes mellitus), then a severe heart attack can recur. Antihypertensive drugs, hypoglycemic agents, and blood thinners are prescribed to prevent a recurrent episode of acute ischemia.
Disseminated encephalomyelitis
Disseminated encephalomyelitis (REM) is an acute pathology of the central nervous system. In this disease, the myelin sheath of the nerve fibers is destroyed. The perivascular spaces of Virchow - Robin are enlarged due to the defeat of the white and gray matter. Demyelination foci are visible on the MRI image.
This pathology has an autoimmune origin. The clinical picture of the disease resembles the symptoms of multiple sclerosis. Patients have gait and movement disorders, speech disorders, dizziness, inflammation of the optic nerve.
Unlike many other demyelinating diseases, REM is treatable. Sickprescribe corticosteroids to suppress the autoimmune response:
- "Prednisolone";
- "Dexamethasone";
- "Metipred".
After a course of therapy, 70% of patients recover completely. In advanced cases, the consequences of the disease may persist in patients: sensory disturbances in the limbs, gait disturbances, visual disturbances.
Prevention
How to prevent the above pathologies? It can be concluded that elderly patients are more susceptible to such diseases. Therefore, all people over the age of 60 should regularly visit a neurologist and undergo an MRI examination of the brain.
It is also important to constantly monitor the level of cholesterol in the blood and blood pressure. After all, diseases accompanied by pathological changes in the white matter most often develop against the background of atherosclerosis and hypertension.
