Felix, Ana C.Fernandes, NadiaGuilherme, PatriciaNzwalo, Hipólito2017-04-072017-04-0720161747-4930http://hdl.handle.net/10400.1/9778Dear editor, Brain perivascular spaces (PVSs) or Virchow-Robin spaces are pial-lined, interstitial fluid-filled structures surrounding the arteries entering brain parenchyma.1 Enlarged PVSs are radiological manifestation of posttraumatic encephalopathy2 and a common biomarker of small vessel disease (SVD).3 Exuberant forms of PVSs are rarely reported. A 55-year-old male truck driver, retired professional boxer with a history of severe untreated hypertension, obesity, brainstem lacunar stroke, dyslipidemia, heavy smoking, right sided severe internal carotid stenosis (SICS) (90–99%) and hyperhomocysteinemia was brought to the emergency room because of sudden onset of right hemiparesis followed by focal complex hemiconvulsionengjournal article10.1177/1747493015607374