Are Virchow-Robin Spaces Normal or Dangerous? Exploring the Basics

If you’re one of those who has recently undergone brain imaging, chances are you’ve heard of a “Virchow-Robin space”, or perhaps noticed it in your radiology report. If you’re curious about this term and looking for answers, read on.

What is the Virchow-Robin space?

The Virchow-Robin space, also called perivascular space, is a natural structure present in the brain and spinal cord. It refers to a tiny fluid-filled cavity (~10 micrometers wide) that surrounds the blood vessels as they enter the brain and branch out. These spaces are lined by a layer of cells called perivascular astrocytes and filled with cerebrospinal fluid (CSF), the fluid that cushions the brain and spinal cord.

Scientists have known about these spaces since the mid-19th century when two scholars, Rudolf Virchow and Charles Robin, independently described them. However, they remained understudied for many years due to difficulties in visualizing them and interpreting their function.

Does everyone have Virchow-Robin spaces?

Yes, the Virchow-Robin spaces are considered a normal feature of the human brain, and everyone has them to some extent. The spaces are particularly prominent in the basal ganglia, thalamus, and white matter regions, but can also be seen in other areas of the brain.

As we age, there may be an increase in the number and size of the Virchow-Robin spaces, but this varies from person to person and is not necessarily a cause for concern.

Are Virchow-Robin spaces dangerous?

In general, small and asymptomatic Virchow-Robin spaces are seen as a benign finding on imaging and do not pose any risk to health. These spaces are typically discovered incidentally during scans done for other reasons and are not something to worry about.

However, in some cases, Virchow-Robin spaces can become enlarged or dilated, causing them to be seen more readily on imaging. This can occur due to various reasons, such as inflammation, infection, or age-related changes. When this happens, the spaces may mimic other more concerning findings such as cysts, abscesses, or tumors, leading to anxiety and further investigation.

Can Virchow-Robin space be treated?

As Virchow-Robin spaces are considered a normal part of the brain’s anatomy, there is usually no need for treatment or intervention in the case of small or asymptomatic spaces. However, in rare instances where they become enlarged and cause symptoms such as headaches, neurological deficits, or stroke-like symptoms, treatment may be necessary.

The management of Virchow-Robin space enlargement depends on the underlying cause. If the dilation is due to inflammation or infection, treating the causative factor may lead to resolution of the spaces. In cases where the spaces are causing neurological symptoms, endoscopic or surgical drainage may be required.

Dilated Virchow-Robin Space Radiology

On radiology imaging such as MRI or CT scans, dilated Virchow-Robin spaces can appear as small well-defined fluid-filled lesions along the course of blood vessels, usually <5mm. They may or may not be associated with other features such as surrounding edema, an enhancing wall, or mass effect, which can help differentiate them from other lesions.


In summary, the Virchow-Robin space is a normal structure present in the human brain and spinal cord that surrounds blood vessels and is filled with cerebrospinal fluid. Small and asymptomatic spaces are usually not concerning, but larger or symptomatic spaces may require further investigation or treatment depending on the underlying cause. If you have concerns about Virchow-Robin spaces or other anomalies seen on your brain scan, it’s best to discuss them with your doctor for a proper evaluation and recommendation.