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Introduction: As the human brain ages, characteristic structural changes occur that are considered to be normal and are expected. Thus the thorough knowledge of the age related normal changes that occur in the brain is required before any abnormal findings are analyzed. As ageing advances, the brain undergoes many gross and histopathological changes with regression of the brain tissue leading to the enlargement of the ventricles. To understand these changes the knowledge of normal morphometry and size of normal ventricular system of brain is important. Materials & Methods: For the present study 358 (Males – 207 and Females – 151) individuals Computerized Tomography (CT) images of brain studied. Measurements of fourth ventricle, third ventricle and lateral ventricle were noted down from CT images and it was statistically analyzed. Results: After analysis it was observed that the height and width of the fourth ventricle was larger in males as compared to females. The length of the third ventricle was observed to be greater in females than in males. The width of the third ventricle it was observed to be greater in males than in females. Antero-posterior extent of the left frontal horn (males = 26.26 ± 2.94, 95% CI 25.86 – 26.66 mm and females = 26.53 ± 3.38, 95% CI 25.99 – 27.08 mm) was greater than that of the right ones (males = 25.00 ± 3.18, 95% CI 24.57 – 25.44 mm and females = 25.34 ± 3.50, 95% CI 24.78 – 25.90 mm). Conclusion: Advances in sensitive imaging techniques like the Computerized Tomography helps in dramatic expansion of our understanding of the normal structure of brain. The present study has defined the morphometric measurements of the lateral ventricles, third ventricle, and fourth ventricle of the brain which has clinical correlations in diagnosis and for further line of treatment.
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381
Brij et al., Int J Med Res Health Sci. 2014;3(2): 381-387
International Journal of Medical Research
&
Health Sciences
www.ijmrhs.com Volume 3 Issue 2 (April - Jun) Coden: IJMRHS Copyright @2014 ISSN: 2319-5886
Received: 14th Feb 2014 Revised: 13th Mar 2014 Accepted: 16th Mar 2014
Research Article
VENTRICLES OF BRAIN: A MORPHOMETRIC STUDY BY COMPUTERIZED TOMOGRAPHY
Brij Raj Singh1, Ujwal Gajbe1, Amit Agrawal2, *Anilkumar Reddy Y1, Sunita Bhartiya1
1Department of Anatomy, J.N.M.C, Sawangi, Meghe, Wardha, Maharashtra, India
2Dept of Neurosurgery, Narayana Medical College, Nellore, Andhra Pradesh, India
*Corresponding author email: kumarlucky48@gmail.com,
ABSTRACT
Introduction: As the human brain ages, characteristic structural changes occur that are considered to be normal
and are expected. Thus the thorough knowledge of the age related normal changes that occur in the brain is
required before any abnormal findings are analyzed. As ageing advances, the brain undergoes many gross and
histopathological changes with regression of the brain tissue leading to the enlargement of the ventricles.
To understand these changes the knowledge of normal morphometry and size of normal ventricular system of
brain is important. Materials & Methods: For the present study 358 (Males - 207 and Females - 151) individuals
Computerized Tomography (CT) images of brain studied. Measurements of fourth ventricle, third ventricle and
lateral ventricle were noted down from CT images and it was statistically analyzed. Results: After analysis it was
observed that the height and width of the fourth ventricle was larger in males as compared to females. The length
of the third ventricle was observed to be greater in females than in males. The width of the third ventricle it was
observed to be greater in males than in females. Antero-posterior extent of the left frontal horn (males = 26.26 ±
2.94, 95% CI 25.86 - 26.66 mm and females = 26.53 ± 3.38, 95% CI 25.99 - 27.08 mm) was greater than that of
the right ones (males = 25.00 ± 3.18, 95% CI 24.57 - 25.44 mm and females = 25.34 ± 3.50, 95% CI 24.78 - 25.90
mm). Conclusion: Advances in sensitive imaging techniques like the Computerized Tomography helps in
dramatic expansion of our understanding of the normal structure of brain. The present study has defined the
morphometric measurements of the lateral ventricles, third ventricle, and fourth ventricle of the brain which has
clinical correlations in diagnosis and for further line of treatment.
Keywords: ventricular system, morphometric study, human brain
INTRODUCTION
Man has long been fascinated with workings of
human brain. The structure of human brain is
complicated and not yet fully understood. As the
human brain ages, characteristic structural changes
occur that are considered to be normal and are
expected. Thus the thorough knowledge of the age
related normal changes that occur in the brain is
required before any abnormal findings are analyzed.
There have been a great number of studies examining
the anatomical structure of the human brain and the
age related changes that occur normally. As ageing
advances, the brain undergoes many gross and
histopathological changes with regression of the
brain tissue leading to the enlargement of the
ventricles.1Both imaging and autopsy studies
revealed that there is correlation with increase in
cerebrospinal fluid spaces and reduction in cerebral
volume accompanying normal human ageing.2, 3 Due
to these changes that occurs normally with ageing,
the diagnosis of diseases in elderly patients is often
DOI: 10.5958/j.2319-5886.3.2.079
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Brij et al., Int J Med Res Health Sci. 2014;3(2): 381-387
complicated. So, the two major changes that may
occur in elderly individual without neurologic deficits
is enlargement of ventricles and cortical atrophy.
However surprisingly, there is lack of clinical,
radiologic and pathologic information regarding these
changes in humans. The normal ventricular size
during life was previously unknown.
In the past, the pneumoencephalogram was the most
valuable test for determining ventricular size during
life. Advances in sensitive imaging techniques like
the Computerized Tomography helps in dramatic
expansion of our understanding of the normal
structure of brain without the use of contrast media.
Computerized Tomography also provided a
revolutionary means for morphologic study of the
brain in vivo. Some authors found gender differences
in brain atrophy with ageing and revealed that the
degree of change was milder in women than in men.5
Enlargement of cerebrospinal fluid spaces during
ageing is generally diffused.6There is regression of
thalamic nuclei after 50 years of age which explains
demonstration of early third ventricular enlargement.4
There is more shrinkage with age in the frontal
cortex, brain stem and dienchephalic structure7. Also
the left lateral ventricle is normally larger than the
right.8Various studies clearly shows an increase in
the CSF spaces in dementia especially in Alzheimer’s
disease and Parkinson’s disease.9This was due to
reduction in size of the nerve cells.10 ventricular
enlargement to be a more sensitive indicator of
cortical atrophy due to increasing age and
dementias.11 Studies show there was enlarger of the
lateral ventricles in epilepsy and also in depression.12
To understand these changes the knowledge of
normal morphometry and size of normal ventricular
system of brain is important.
Aims and objectives
1) The aim of the study to analyze the morphometric
measurements of ventricular systems of the brain in
different age group individuals of both genders.
2) To study the symmetry of lateral ventricle on
either side and to compare the result of this study
with previous study.
MATERIAL AND METHODS
This was the prospective study in which
Computerized Tomography images of total 358
(Males - 207 and Females - 151) in which 270 adult
individuals (Age Group 20-60 years) and 88 ageing
individuals (Age above 60 years) of either sex
attending the Department of Radiodiagnosis,
A.V.B.R.H., Jawaharlal Nehru medical college from
the year between January 2010 to august 2011. The
criteria for exclusion of individuals in this study
were:
1) Individuals below 20 years of age
2) Any history of local mass lesion in brain
3) Any history of cerebral infarction
4) Any history of hydrocephalus
5) Any history of alcoholism, drug abuse and trauma
or previous history of intracranial surgery
Computer tomography of these patients was
performed on PHILIPS BRILLIANCE MULTI
SLICE (16 SLICE) MULTI DETECTOR SPIRAL
CT SCANNERwith a scan time of 1-10 sec and
slice thickness of 5 mm in the posterior cranial fossa
and 10 mm in above region. Study protocol was
submitted to the institutional ethical committee and
their permission was obtained. The patient was placed
on the Computerized Tomography table in supine
position and head was centered to the cris-cross point
of the light beam was made to coincide with the
orbito-meatal line. This position represented the zero
table position.13 The Computerized Tomography scan
images of the brain taken up to the highest level of
cranial vault and it was statistically analyzed.
The following measurements were made from the CT
images which obtained by the standard protocol made
by the radiological society. :
1. Measurement of the fourth ventricle
a). Vertical diameter - Greatest vertical distance
length (mm) of the fourth ventricle (from upper
margin of pons to lower limit of open part of medulla
oblongata). (Figure no. 4 and 5)
b). Transverse diameter - Greatest transverse
diameter measures in mm (maximum transverse
distance along the coronal plane). (Figure no.3)
2) Measurement of third ventricle (Figure no.4)
a) Greatest vertical diameter - height (mm) in
transverse plane in antero-posterior extent.
b) Greatest transverse diameter - transverse diameter
measures in (mm) maximum in coronal plane.
3) Measurement of lateral ventricle of right and left
side. (Figure no.5)
a) Greatest anterior-posterior extent measures in
(mm) for frontal horn of the lateral ventricle.
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b) Greatest anterior-posterior extent measures in mm
for frontal horn and including body of the lateral
ventricle.
RESULTS
Table no. 1 shows the measurements of height of
fourth ventricle. After analysis it was observed that
the height of the fourth ventricle was larger in males
(12.18 ± 1.54, 95% CI 11.97 - 12.39 mm) as
compared to females (12.13 ± 1.41, 95% CI 11.91 -
12.36 mm), which was statistically insignificant
(T=0.314 p= 0.753). Table no. 1 shows the
measurements of maximum width of fourth ventricle.
The width of the fourth ventricle was observed to be
greater in males (11.07 ± 1.54, 95% CI 10.85 - 11.28
mm) than in females (11.05 ± 1.31, 95% CI 10.84-
11.26 mm), which was also statistically insignificant
(T= 0.129 p=0.897).Table no. 2 shows the
measurements of length of third ventricle. The length
of the third ventricle was observed to be greater in
females (18.86 ± 8.36, 95% CI 17.52 20.21 mm)
than in males (17.97 ± 2.76, 95% CI 17.59 -18.35
mm), which was statistically insignificant (T= -1.429
p= 0.154). Table no. 3 show the measurements taken
of the third ventricle. After analysis of the width of
the third ventricle it was observed to be greater in
males (3.47 ± 1.07, 95% CI 3.32 - 3.62 mm) than in
females (3.31 ± 0.94, 95% CI 3.16 - 3.46 mm) and
this difference was statistically insignificant (T=
1.470 p= 0.164).Table no. 4 shows various
measurements taken of the lateral ventricles. On
analyzing these it was observed that the antero-
posterior extent of the left frontal horn (males = 26.26
± 2.94, 95% CI 25.86 - 26.66 mm and females =
26.53 ± 3.38, 95% CI 25.99 - 27.08 mm) was greater
than that of the right ones (males = 25.00 ± 3.18, 95%
CI 24.57 - 25.44 mm and females = 25.34 ± 3.50,
95% CI 24.78 - 25.90 mm). Same thing also observed
in the antero-posterior extent of the left lateral
ventricular body including its frontal horn (males =
56.70 ± 6.61, 95% CI 55.79 - 57.61 mm and females
= 56.28 ± 7.59, 95% CI 55.06 - 57.50 mm) was
greater than the right one (males = 55.78 ± 6.15, 95%
CI 54.94 - 56.63 mm and females = 55.10 ± 6.99,
95% CI 53.97 - 56.22 mm).Table no. 5 shows the age
wise distribution of the length of right sided lateral
ventricle frontal horn with body, right sided lateral
ventricle frontal horn, width of the third ventricle and
width of the fourth ventricle. It was observed that as
the age advances dimensions of the ventricles also
enlarges and this difference was statistically
significant by ANOVA test for length of right Lateral
Ventricle (Frontal horn with body) f=26.77
p=0.000, length of right Lateral Ventricle (Frontal
horn) f=15.46 p=0.000, Width of third ventricle
f=3.89 p=0.021 and for the Width of fourth ventricle
value is f=0.49 p=0.614 (Not significant).
Table 1: Measurements of Fourth Ventricle (mm)
Height
width
Males (n=207)
Females (n=151)
Males (n=207)
Mean ± SD Units
12.18± 1.54
12.13± 1.41
11.07± 1.54
95% CI (L)
11.97
11.91
10.85
95% CI (U)
12.39
12.36
11.28
T Value
0.314
0.129
P Value
0.753
0.897
<0.05 (Not significant)
Table 2: Measurements of Third Ventricle (mm)
Length
width
Males (n=207)
Females (n=151)
Males (n=207)
Females (n=151)
Mean ± SD
17.97± 2.76
18.86± 8.36
3.47± 1.07
3.31± 0.94
95% CI (L)
17.59
17.52
3.32
3.16
95% CI (U)
18.35
20.21
3.62
3.46
T Value
-1.429
1.470
P Value
0.154
0.164
<0.05 (Not significant)
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Brij et al., Int J Med Res Health Sci. 2014;3(2): 381-387
Table 3: Measurements of Lateral Ventricle (mm)
Fourth Ventricle
Frontal horn
Frontal horn + body
Males (n=207)
Females (n=151)
Males (n=207)
Females (n=151)
R
L
R
L
R
L
R
L
Mean ± SD
25.00±3.18
26.26±2.94
25.34±3.50
26.53±3.38
55.78± 6.15
56.70± 6.61
55.10± 6.99
56.28± 7.59
95% CI (L)
24.57
25.86
24.78
25.99
54.94
55.79
53.97
55.06
95% CI (U)
25.44
26.66
25.90
27.08
56.63
57.61
56.22
57.50
Table No. 4: Ventricular enlargement (age wisedistribution in mm).
Age
groups
(Yrs)
Length of Rt. Lat.
Ventricle (Frontal
horn with body)
Length of Rt. Lat.
Ventricle (Frontal
horn)
Width of 3rd
ventricle
Width of 4th
ventricle
Mean ± SD
Mean ± SD
Mean ± SD
Mean ± SD
20-40
52.23±4.80
23.93±2.34
3.22±0.76
10.93±1.46
41-60
55.80
6.18
25.44
3.20
3.33
0.90
11.09
1.38
>61
57.73
6.92
25.92
3.77
3.61
1.30
11.06
1.53
Fig 1: Maximum upper extent of the fourth ventricle
for vertical dimension
Fig 2: Maximum lower extent of the fourth ventricle
for vertical dimension
Fig 3: Maximum width of the fourth ventricle for
vertical dimension
Fig 4: ab = maximum antero-posterior dimension
of third ventricle, c d =maximum width of third
ventricle
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Brij et al., Int J Med Res Health Sci. 2014;3(2): 381-387
Fig 5: ab = maximum antero-posterior dimension
of right frontal horn with body at the level of
interventricular foramina of the lateral ventricle, c d
=maximum antero-posterior dimension of left frontal
horn with body at the level of interventricular
foramina of the lateral ventricle
DISCUSSION
The human nervous system is the most complex,
widely investigated with recent advance tools like CT
and MRI scan but yet poorly understood physical
system known to the mankind.14-18 many studies
reveals that brain regression involving cerebrum and
cerebellum usually begins at the age in the beginning
of seventh decade and thereafter accelerated as age
advances. Lateral ventricular contours are relatively
constant, except for the occipital horns.19 The
ventricular system can be better visualized by using
modern computerized x-ray tomography, which
allows easy and safe noninvasive study without
complications and it can be used as a screening
procedure for many pathological conditions.4, 20-23
Roberts et al revealed that the value in evaluating
dementia and its use in excluding brain diseases like
neoplasm’s, subdural hematomas, and
cerebrovascular disease that may mimic like
dementia.23 The ventricular size changes in the brain
encountered in routine clinical practices can mislead
to most of the physicians and surgeons to take proper
decision. However, there is likely to be an increasing
number of circumstances in which precise
measurements will be needed. Gawler et al13 (1976)
revealed that the greatest distance between the roof
and the floor of the fourth ventricle was less than 1.2
cms with a mean of 1.08 cms; however in the present
study this distance is significantly larger in males
(12.18 ± 1.54, 95% CI 11.91 - 12.39 mm) than in
females (12.13 ± 1.41, 95% CI 11.91 - 12.36 mm)
(Table no. 1). In the present study, the height of the
fourth ventricle was found to be greater than the
width in both genders. Width of the fourth ventricles
is more in males (11.07 ± 1.54, 95% CI 10.85 - 11.28
mm) than in females (11.05 ± 1.31, 95% CI 10.84-
11.26 mm) (Table no. 2).Brinkman et al 24 (1981),
Soininen et al 25 (1982), D'Souza e Dias Medora C.et
al 26 (2007) found that the maximum width of the
third ventricle had a mean of 0.46 cms, 0.59 cms,
0.92 ± 2.71 cms and 0.45 ± 0.29 cms respectively,
with higher values in males. In the present study this
measure was found to be significantly higher in males
(3.47 ± 1.07, 95% CI 3.32 - 3.62 mm) as compared to
females (3.31 ± 0.94, 95% CI 3.16 - 3.46 mm) (Table
no. 3).According to Glydensted 8(1977), Gomori et
al 27 (1984) Takeda and Matsuzawa 28 (1985),
Goldstein et al 29 (2001) and D'Souza e Dias Medora
C. et al 26 (2007) the left lateral ventricle was larger
than the right one and both were larger in males. In
present study, the anteroposterior extent of the left
frontal horns (males = 26.26 ± 2.94, 95% CI 25.86 -
26.66 mm and females = 26.53 ± 3.38, 95% CI 25.99
- 27.08 mm) was greater than that of the right ones
(males = 25.00 ± 3.18, 95% CI 24.57 - 25.44 mm and
females = 25.34 ± 3.50, 95% CI 24.78 - 25.90
mm).The antero-posterior extent of the left lateral
ventricular bodies including their frontal horns (males
= 56.70 ± 6.61, 95% CI 55.79 57.61 mm and
females = 56.28 ± 7.59, 95% CI 55.06 57.50 mm)
was greater than the right ones (males = 55.78 ± 6.15,
95% CI 54.94 56.63 mm and females = 55.10 ±
6.99, 95% CI 53.97 56.22 mm) (Table no. 5).
CONCLUSION
The structure of human brain is complicated and yet
not fully understood till date. As the human brain
ages, characteristic structural changes occur that can
be considered normal and are expected too. Advances
in sensitive imaging techniques like the
Computerized Tomography helps in dramatic
expansion of our understanding of the normal
structure of brain. The purpose of this study was to
examine the different dimensions of ventricular
system.
The present study has defined the morphometric
measurements of the lateral ventricles, third ventricle,
and fourth ventricle of the brain which has clinical
correlations in diagnosis and for further line of
treatment.
386
Brij et al., Int J Med Res Health Sci. 2014;3(2): 381-387
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... male had higher values than female. In accordance a couple of related studies were reported significant difference between male and female in mean anterior-posterior length of third ventricle and male had greater value than female [14][15][16][17][18][19][20][21][22][23][24][25][26]. ...
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... To understand these changes, the knowledge of normal morphometry and the size of the normal ventricular system of the brain is important. [8] Normal reference values of brain ventricles obtained by MRI are necessary to create baseline data for interpreting pathological changes, planning surgery, and determining the presence and progress of some neurological disorders. ...
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... "As the human brain ages, characteristic structural changes occur that are considered to be normal and are expected. Thus the thorough knowledge of the age related normal changes that occur in the brain is required before any abnormal findings are analyzed" [14]. ...
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Aim: To determine the bi-caudate index (BCI) of Nigerians using computerized tomography from Sokoto North-Western Nigeria. Study Design: Retrospective cross- sectional. Place and Duration of Study: Department of Anatomy Usmanu Danfodiyo University Sokoto and Department of Radiology Usmanu Danfodiyo University Teaching Hospital Sokoto, between January, 2020 and January, 2022. Methodology: CT scans of 186 apparently healthy normal individuals of age group 1 to 70 years were taken and the subjects were categorized into age intervals of 10 years; males and females taken separately. The linear measurements of caudate and brain were taken directly from the screen. The Bi Caudate Index were calculated. The mean values in each group were compared with age and sex, using appropriate statistical tests. Results: The least BCI in male was 6.0mm and was seen in the age group 1-10 years while in female the least BCI was 5.0mm, seen in the age group 1-10. The largest BCI in male was 21mm, observed in the age group 61-70years, while the largest BCI in female 19.0mm, seen in the age group 61-70 years. Conclusion: Bi Caudate Index shows positive correlation with age.
... Mean length of fourth ventricle was higher in males than in females, but the difference was nonsignificant. Range and variation were also higher in males than in females The finding are in accordance with those of study by Singh et al.,10 (mean height: 12.18±1.54 [males]; 12.13±1.41 ...
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Background: Size of fourth ventricle varies in different pathologies, in the context of enlarged brain ventricles size observed in routine clinical practices, knowledge of the usual range of exact measurement is required. Aims and Objectives: This study is hospital-based observational study to derive normal measurement range of fourth ventricle and correlating it with measurements of cerebrum and age of patients. Materials and Methods: Hospital-based prospective study was conducted in the department of radiodiagnosis in a teaching medical college. Patients with virtually normal study on unenhanced head CT scan of both sex and age groups from 2 year to 60 years, were included in the study. Patients with CT scans showing gross pathological changes affecting the normal anatomy of ventricles were excluded from the study. Results: The mean age of the cases was 37.0±16.88 years. Mean fourth ventricle anterioposterior dimension is 7.5±2.5 mm and transverse dimension is 12±3.1 mm. Anteroposterior diameter of fourth ventricle showed non-significant correlation (r=0.06, P=0.56) with anteroposterior diameter of skull and no significant correlation with (r=0.07, P=0.45) transverse diameter (TD) of skull. AP diameter of fourth ventricle showed a positive correlation with age, which was statistically significant (r2=0.698, P=0.01). TD of fourth ventricle showed slight positive correlation (r=0.202 P=0.048) with anteroposterior diameter of skull and (r=0.142, P=0.168) TD of skull whereas nil with. TD of fourth ventricle showed a positive correlation with age, which was statistically non-significant (r2=0.659, P=0.01). It increases with age. Conclusion: Knowledge of normal measurements helps in assessing, dilated fourth ventricle in various pathologies.
... The mean length of the frontal horn of lateral ventricles of brain was 2-4 mm more in the present study when compared to 8 that of D'Souza et al study (2007) . It is 4-5mm more when 9 compared to Brij et al study (2014) and 2-4mm when 10 compared to Gameraddin et al study (2015) . ...
Article
Introduction The cerebral ventricular system consists of a series of interconnecting spaces and channels which originate from the central lumen of the embryonic neural tube. The ventricular system lled with cerebrospinal uid, is an essential part of the brain. Understanding the normal anatomy and the variations of the ventricular system of brain is helpful for clinicians, neurosurgeons and radiologists in day-to-day clinical practice1. Aims And Objectives To determine the average dimensions and variations of the frontal horn of the normal lateral ventricles of brain by CT scan. Materials And Methods The study was conducted in individuals who attended the Department of Radiodiagnosis in Government Medical College, Thiruvananthapuram. Those patients whose brain CT scans were read as normal by the radiologist were taken up for the study. A total of 200 CT brain of individuals above 10 years of age were taken during the period from January 2017 to June 2018.100 males and 100 females were included in the study group. Results The length of the frontal horn of lateral ventricle of brain was found to be more on the left side and in male gender. It was also observed to be increasing with age. Conclusion The present study outlines the normal values of the length of frontal horn of the lateral ventricles of brain using Computerized tomography which would aid in the diagnosis and management of neurological disorders.
... This result was not in line with a study done in India, which reported as no statistically significant difference was found between any of the age groups (p>0.05) [3]. This might be due to the sample size different in each age group in the present study. ...
Article
Background: Knowledge of the frontal horn size is necessary for the initial and precise analysis of Ventriculomegaly. Therefore, having a baseline reference value of the frontal horn size will be beneficial in a huge vary of medical pathologies. The purpose of this study was to determine the frontal horn of lateral ventricle size and its correlation with age among adult patients in the
... , which is so significant at R 2 = 0.61, where x refers to age in years and y refers to brain ventricle volume in cm. such result could be ascertained by the study done by Brij et al, [20], in which he found that: a gradually progressive increase in ventricular size from the first through sixth decades followed by dramatic increase in the eighth and ninth decades. Figure 6 shows the correlation between age groups in years and cranial volume in mm 3 for male and female. ...
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A volumetric study has been carried out using CT imaging to measure the cranial volume and correlate with the common pathologies that influencing their dimension such as brain ventricle volume and cranial volume. The study taking a sample of 150 patients referred to hospital for CT imaging version (GE-bright speed 16 slice-2002). And according to basic protocol, spiral scanning with equal slice thickness and interval space, patient without contrast media, supine position, head first, orbito-metal line as anatomical reference, radiographic base line (RBL) perpendicular to couch, and the reconstruction of images have been carried out according to organ of interest for diagnosis. The results showed that: the incidence of pathologies that influencing the brain ventricle volumes and cranial volume was higher among male with 62% relative to 38% among female and the common pathology that influences the cranial and brain volume was the hydrocephalus taking a percent of 40.5%, mixed (hydrocephalus and tumor) represents 23%, tumors 21.5% and schizophrenia 15%. In relation to age groups, these pathologies have been peaking on age groups 1-10 years old which representing (40%) and among age groups of 55-65 years old 25%. The age was correlated with ventricle and cranial volumes in a form of linear proportional equation: (y = 0 .71x +12.12) and (y = 18.35x + 2776), where x refers to age in years and y refers volume of ventricle and cranial in cm 3. In relation between cranial volumes with age among both gender: The cranial volume increases by aging among male and female up to 21-30 years old, then became semi-constant after, and the male cranial volume was 3191.7± STD114 cm 3 which is greater than in female which was 3133 ± STD124 cm 3 in average. While the relation between the ventricle volumes and age groups for both genders, revealed that: the brain ventricles volume increase with aging among both genders, in a relation that could be fitted in the following form: (y = 5.97x + 2075) among male and (y = 5.61x + 13.48) among female, where x refers to age in years and y refers to ventricle volume in cm3. The correlation so significant at R2 = 0.8, and the ventricles volumes of male appear greater than in female i.e. 50.6± STD17.9 for male and 41.5± STD17.3 for female. The ratio of ventricle\cranial volumes have been influenced by cranial pathologies, leading to increment of ventricular\cranial ration as follows: for mixed i.e. (tumor\hydrocephalus) representing 0.06, hydrocephalus 0.1, tumor 0.02 and schizophrenia was 0.03 relative to normal case which was 0.01.
... F. Duffner et al. 31 D'soza et al. 24 found the mean height of 4th ventricle as 38.3 mm and 11.8 mm; mean width were 12.5 mm and 13.1 mm with MRI and CT respectively. Akbari VJ et al. 32 found that width (23.8 mm) is more than height (22.9 mm) of fourth ventricle. ...
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Introduction: The lateral ventricle, which is the largest among all ventricles of the brain, can be divided into the frontal horn, body, posterior horn, and inferior horn. Various methodologies may produce different results in measuring the length of the lateral ventricle. Aim: To determine whether there are any differences in the lengths of the lateral ventricle when measured using formalin-fixed brain specimens and Magnetic Resonance Imaging (MRI) scans. Materials and Methods: This cross-sectional study was conducted from April 2014 to March 2019 in the Department of Anatomy at Silchar Medical College and Hospital, Assam, India. A total of 127 formalin-fixed cadaveric brain specimens were used to measure the lengths of different parts of the lateral ventricle using a Vernier Calliper. Additionally, MRI scans of 35 patients were used to measure the same lengths. The mean values of the lateral ventricle lengths measured in formalin-fixed brain specimens and MRI scans were compared using Student's t-test to determine statistical significance. Furthermore, variations in the lengths of the lateral ventricle according to age and gender were also measured using MRI. Results: Among the 127 brain specimens, 78 were from male brains and 49 were from female brains. Out of the 35 MRI scans, 23 were from male cases and 12 were from female cases. The average length of the frontal horn, body, and inferior horn was found to be greater in MRI scans (34.83 mm, 54.37 mm, and 51.09 mm, respectively) compared to the dissection method in cadavers (30.64 mm, 35.49 mm, and 42.29 mm, respectively). All parts of the lateral ventricle measured in MRI scans were found to have greater lengths in males, although the difference was not statistically significant. Conclusion: A significant difference was observed when comparing the lengths of the lateral ventricle measured in MRI scans and formalin-fixed cadaveric brain specimens.
Article
Objectives The defining of the normal parameters of spacious relations and symmetry of the ventricular system of the brain depending on the gender and age is currently one of the topical research problems of clinical anatomy. The present research aims to identify the correlation between the morphometric parameters of the third ventricle of the brain and the shape of the skull in the middle-aged people. Design This is a prospective cohort study. Setting This study was set at the Trinity School of Medicine. Participants A total of 118 normal computed tomography scans of the head of people aged from 21 to 86 years (mean age: 48.6 years�17.57) were selected for the study. Main Outcome Measures The anteroposterior diameter, transverse diameter, and height of the third ventricle were measured and compared in dolichocranial, mesocranial, and brachycranial individuals. Results The study has shown the presence of a statistically significant difference between morphometric parameters of the third ventricle of the brain in dolichocranial, mesocranial, and brachycranial individuals. Conclusion The morphometric parameters of the third ventricle of the brain, such as height, anteroposterior diameter, and transverse diameter depend on the individual anatomic variability of the skull shape and gender.
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Computerized tomography was used to evaluate 35 patients with senile dementia and proved to be a simple and practical screening procedure. Those patients with moderate or severe cerebral atrophy had a poorer short-term prognosis than those with questionable or mild atrophy. Two patients with potentially treatable illnesses (hypothyroidism and pernicious anaemia) and only questionable atrophy had reversal of the dementia with treatment. A single patient with moderate atrophy had a potentially treatable illness (hypothyroidism) which only partially resolved. Those patients with dementia but relatively little atrophy by computerized tomography may represent a unique group with a better prognosis who require particularly careful evaluation for potentially treatable illnesses.
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More than 20,000 autopsy reports from several general hospitals were surveyed for the purpose of selecting brains without a pathological lesion that had been weighed in the fresh condition. From this number, 2,773 males and 1,963 females were chosen for whom body weight, body height, and cause of death had been recorded. The data were segregated into 23 age groups ranging from birth to 86+ years and subjected to statistical evaluation. Overall, the brain weights in males were greater than in females by 9.8%. The largest increases in brain weights in both sexes occurred during the first 3 years of life, when the value quadruples over that at birth, while during the subsequent 15 years the brain weight barely quintuples over that at birth. Progressive decline in brain weight begins at about 45 to 50 years of age and reaches its lowest values after age 86 years, by which time the mean brain weight has decreased by about 11% relative to the maximum brain weight attained in young adults (about 19 years of age). Computed regression lines for brain weights versus body heights and body weights and for ratios of brain weights to body heights and weights versus age groups show clearly differential rates of change in brain weights which are less affected by sex.
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All linear measurements employed for evaluation of brain atrophy, were performed on 148 computed tomograms of patients aged 28 to 84 without evidence of any nervous system disorder. These included size of lateral, third and fourth ventricles, width of the Sylvian and frontal interhemispheric fissures and cortical sulci and size of the pre-pontine cistern. Various parameters indicated decrease in brain mass with age. Since the atrophic process is a diffuse phenomenon, integration of several measurements evaluating separate brain regions was made. The bicaudate ratio and the Sylvian fissure ratio (representing both central and cortical atrophy) were cominbed arithmetically, resulting in a correlation of 0.6390 with age (PP
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The brains of 100 normal adults were examined with 160 X 160 matrix computed tomography (CT). The left lateral ventricle was found to be larger than the right in both sexes, and both lateral ventricles were larger in the male. There was a statistically significant increase of all cerebral parameters with age, and the cella media index showed a correspondingly small decrease with age. The linear measurements of the lateral ventricles demonstrated positive correlation to cranial size, while the widths of the third ventricle and of the hemispheric sulci were independent of the size of the skull.
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One hundred thirty-five normal volunteers were examined by computerized tomography (CT) and their ventricular size was measured by planimetry. A pattern of change in ventricular size from the first through the ninth decades was discerned and quantified. A gradually progressive increase in ventricular size from the first through sixth decades was followed by a dramatic increase in the eighth and ninth. The range of normal ventricular size was relatively more wide in the eighth and ninth decades than in the first seven; thus, abnormalities of ventricular size may be more easily identified in younger than older subjects. These data are more valuable than those from pneumoencephalography or autopsy studies because CT is not subject to the artifact inherent in those procedures.
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Sixty-six elderly subjects (mean age 77 years) whose mental state was assessed clinically and by simple psychometric tests have been studied by computerised tomography. The mean maximum ventricular area in the 17 mentally normal subjects was above the upper limit of normal for younger subjects, and there was a broad relationship between increasing ventricular dilatation and increasing intellectual impairment. No such clear relationship was demonstrable for measures of cortical atrophy.
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Computed tomography of the brain was used in evaluating demented and nondemented elderly people. The incidence of convulutional atrophy and ventricular enlargement correlated well with pathologic and pneumoencephalographic examination of a similar population. Computed tomography also showed certain instances of dementia without atrophy and evidence of atrophy without dementia. The absence of brain atrophy in a demented patient should prompt a search for a potentially treatable cause of the dementia. The authors discuss criteria for diagnosing atrophy by computed tomography and conclude that, because of its noninvasive nature, it is a valuable aid in screening demented patients for treatable diseases.
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Computerized tomography, using the EMI Scanner, allows the diagnosis of cerebral atrophy or hydrocephalus to be made with the same degree of accuracy as conventional neuroradiological methods. Ventricular measurements made on EMI scans have been compared with those from pneumoencephalograms and ventriculograms. A range of normal ventricular measurements for the EMI scan is suggested.