Lacunes may be confused with other empty spaces, such as enlarged perivascular Virchow-Robin spaces (VRS).
The VRS are extensions of the subarachnoid space that accompany vessels entering the brain parenchyma.
Widening of VRS often first occurs around penetrating arteries in the substantia perforata and can be seen on transverse MRI slices around the anterior commisure, even in young subjects (5).
Below is CT- and MR-images at the level of the anterior commisure (blue arrows).
Below is a hypodense area in the right hemisphere, which follows the signal intensity of CSF on T2W- and FLAIR-images, which is typical for widened VRS.
In case of infarction, this area marked with yellow arrow should be seen with subttle hyper intensity in Flair sequence.
While in case of VRS, It should follow the signal of CSF.
By another word, if we do T2 image and we find this hyperintense lesion, do flair sequence, if the lesion is still hyperintense, so it will be an infarction but if it follows the signal of CSF, it will be VRS.
The VRS are extensions of the subarachnoid space that accompany vessels entering the brain parenchyma.
Widening of VRS often first occurs around penetrating arteries in the substantia perforata and can be seen on transverse MRI slices around the anterior commisure, even in young subjects (5).
Below is CT- and MR-images at the level of the anterior commisure (blue arrows).
Below is a hypodense area in the right hemisphere, which follows the signal intensity of CSF on T2W- and FLAIR-images, which is typical for widened VRS.
In case of infarction, this area marked with yellow arrow should be seen with subttle hyper intensity in Flair sequence.
By another word, if we do T2 image and we find this hyperintense lesion, do flair sequence, if the lesion is still hyperintense, so it will be an infarction but if it follows the signal of CSF, it will be VRS.
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