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Perivascular spaces (PVS) are physiologic spaces surrounding small blood vessels as they run from the subarachnoid space through the brain parenchyma. Dilation of PVS can be seen on brain MRI, on which they have a signal consistent with the CSF and may be a marker of PVS dysfunction. PVS are believed to be important conduits for removal of metabolic waste and maintenance of homeostatic fluid circulation in the brain as part of the “glymphatic system.”2 This has led to the suggestion that enlarged PVS reflect impairment of brain fluid and waste clearance. The role of brain fluid clearance is an exciting and rapidly advancing research area, yet there is much we do not yet know. One way to discern the relevance of enlarged PVS is to better understand the factors associated with their dilation. However, to date, most previous studies examining associations with PVS have been relatively small.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 60
- Received August 22, 2022.
- Accepted in final form September 7, 2022.
- © 2022 American Academy of Neurology
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