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Objective To improve doctors' understanding of giant perivascular space (PVS) in the brain. Methods A case of giant intracranial polycystic PVS was analyzed retrospectively by searching the databases of PubMed and Medline, combining with literature reports, the anatomy, pathophysiology, clinical manifestations, imaging changes, and treatment principles of giant PVS were summarized. Results A 19-year-old male solder was admitted due to intermittent occipital distension pain for 2 weeks. The brain MRI showed multiple cystic lesions in the right cerebral hemisphere without enhancement. The head-carotid artery CT angiography found no abnormality. The diagnosis was polycystic giant PVS in the brain. His headache was relieved after 3 days of oral compound paracetamol tablets. During a regular follow-up period for 3.5 years, he complained no discomfort. Until October 13, 2020, there were only 41 English articles about brain polycystic giant PVS collected in PubMed, including total of 46 cases. The clinical manifestations were not specific, depending on whether the nerve tissue around PVS was compressed or not. Headache accounted for 32.6%, and hydrocephalus for 43.5%. The MRI of PVS was characterized by its round, oval or tubular structure with a clear, smooth and homogeneous edge, its signal intensity was equal to that of cerebrospinal fluid (CSF) without enhancement. It is called giant or huge PVS when its diameter is more than 15 mm. There was no special treatment unless the giant PVS causes surrounding tissue oppression or hydrocephalus, if so, neurosurgical operation could be help to improve patient's status. Conclusions Characteristics of giant PVS appeared on all sequences of MIR is a CSF-like intensity cystic lesion without enhancement. Clinical attention should be paid to differential diagnosis and follow-up and. If space-occupying effect or hydrocephalus development, it can be intervened by neurosurgery, otherwise no special treatment.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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