Dilated Virchow-Robin space and Parkinson’s disease: A case report of combined MRI and diffusion tensor imaging

In this manuscript we report the case of a 69-year-old female patient, who suffers from Parkinson’s disease (PD) with a dilated Virchow-Robin space (dVRS) on the left anterior per- forated substance. During a magnetic resonance imaging examination, the presence of a dVRS was discov- ered on the left anterior perforated substance. Subsequently, the patient has been subjected to further investigation of magnetic reso- nance imaging and diffusion tensor imaging (DTI). The DTI data of our PD patient showed increased peak frequency of left fractional anisotropy and decreases in the distribution of Mean Diffusivity(MD) with changes in the fiber density compared to the normal contralat- eral tract. We hypothesize that the DTI changes are due to dVRS. In the text a review of the recent literature on the presence of dVRSs, located in mono and bilateral seat, in patients with PD is reported, explaining its possible implications on disease progression, cognitive decline, and worsening of symptoms.