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Morphometric Analysis of the Brain Ventricles in Normal Subjects Using Computerized Tomography

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Abstract Background and Aim: As ageing advances, the human brain undergoes many gross and histopathological changes with regression of the brain tissue leading to the enlargement of the ventricles. Knowledge of morphometric and size of normal ventricular system of brain is important to understand these changes. Methods: For the present perspective study, computerized tomography (CT) for 152 patients (Males—89 and Females—63) were studied for the measurements of fourth ventricle, third ventricle and lateral ventricle and it was statistically analyzed. Results: The anteroposterior extent of the body of the lateral ventricles on the right side was 74.89 + 9.86 mm and 70.06 + 8.83 mm in the males and females and on the left side was 74.89 + 9.89 mm and 69.56 + 11.42 mm in the males and females; the length of the frontal horns on the right side was 28.53 + 3.88 mm and 26.16 + 4.21 mm in the males and females and on the left side was 28.53 + 3.88mm and 26.17 + 4.237 mm in the males and females respectively. The width and height of the fourth ventricle were 12.54 + 1.90 mm and 9.66 + 2.12 in the males and 11.60 + 2.099 mm and 9.70 + 2.219 in the females respectively. The width of the third ventricle was 5.70 + 1.54 mm and 5.40 + 1.68 mm in the males and females respectively. Conclusion: 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 Brain, Morphometry, Ventricular System, Size, Subjects, Tomography
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Open Journal of Radiology, 2015, 5, 13-19
Published Online March 2015 in SciRes. http://www.scirp.org/journal/ojrad
http://dx.doi.org/10.4236/ojrad.2015.51003
How to cite this paper: Gameraddin, M., Alsayed, A., Ali, A. and Al-Raddadi, M. (2015) Morphometric Analysis of the Brain
Ventricles in Normal Subjects Using Computerized Tomography. Open Journal of Radiology, 5, 13-19.
http://dx.doi.org/10.4236/ojrad.2015.51003
Morphometric Analysis of the Brain
Ventricles in Normal Subjects Using
Computerized Tomography
Moawia Gameraddin1,2*, Abdalrahim Alsayed1, Amir Ali3, Mosleh Al-Raddadi4
1Department of Diagnostic Radiologic, College of Medical Applied Sciences Technology, Taibah University,
Almadinah Al Munawwara, Kingdom of Saudi Arabia
2Faculty of Radiological Sciences and Medical Imaging, Alzaiem Alazhari University, Khartoum, Sudan
3Department of Anatomy, Faculty of Medicine, Taibah University, Almadinah Al Munawwara, Kingdom of Saudi
Arabia
4Medical Imaging Department, King Fahad Hospital, Almadinah Al Munawwara, Kingdom of Saudi Arabia
Email: *m.bushra@yahoo.com, a.alrahimtagelsir@yahoo.com, amirmoh.ali@gmail.com, drraddadi@yahoo.com
Received 9 February 2015; accepted 28 February 2015; published 3 March 2015
Copyright © 2015 by authors and Scientific Research Publishing Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/
Abstract
Background and Aim: As ageing advances, the human brain undergoes many gross and histopa-
thological changes with regression of the brain tissue leading to the enlargement of the ventricles.
Knowledge of morphometric and size of normal ventricular system of brain is important to un-
derstand these changes. Methods: For the present perspective study, computerized tomography
(CT) for 152 patients (Males89 and Females63) were studied for the measurements of fourth
ventricle, third ventricle and lateral ventricle and it was statistically analyzed. Results: The ante-
roposterior extent of the body of the lateral ventricles on the right side was 74.89 + 9.86 mm and
70.06 + 8.83 mm in the males and females and on the left side was 74.89 + 9.89 mm and 69.56 +
11.42 mm in the males and females; the length of the frontal horns on the right side was 28.53 +
3.88 mm and 26.16 + 4.21 mm in the males and females and on the left side was 28.53 + 3.88mm
and 26.17 + 4.237 mm in the males and females respectively. The width and height of the fourth
ventricle were 12.54 + 1.90 mm and 9.66 + 2.12 in the males and 11.60 + 2.099 mm and 9.70 +
2.219 in the females respectively. The width of the third ventricle was 5.70 + 1.54 mm and 5.40 +
1.68 mm in the males and females respectively. Conclusion: 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
Brain, Morphometry, Ventricular System, Size, Subjects, Tomography
*
Corresponding author.
M. Gameraddin et al.
14
1. Introduction
The ventricular system of brain is cavity of brain. The two largest ventricles are the lateral ventricles in the ce-
rebrum; the third ventricle is in the diencephalon of the forebrain between the right and left thalamus; and the
fourth ventricle is located at the back of the pons and upper half of the medulla oblongata of the hindbrain [1].
Morphometric studies of human brain ventricles have been under focus by many scholars recently due to it is
relation with pathologies evidences such as hydrocephalus, schizophrenia, tumors, Trauma… etc., as well as
gender and aging which could lead to dementia and or brain geriatric [2] [3]. The advent of CT scanning re-
solved the problem of volumetric measurement performed on normal subjects [4]. The ventricles of the brain are
well visualized, and their overall configuration can be reconstructed from a series of contiguous slices [5]. The
evaluation of the normal measurements of the cerebral ventricles in the living human has great importance in the
diagnosis and monitoring of several pathologies [6]. Accurate measurements of the ventricles provide available
and safe means of aiding the diagnosis of some neurological disorders such as early detection of hydrocephalus,
cerebral atrophy….etc, and provide important follow-up information in affected patients [7]. It should be noted
that there is a continuous debate in the literature of neuro anatomy, psychiatry, neuroradiology and neurology
over the best method of assessing the various parts of the cerebral ventricular system [8].
Little work has been done on measurement of cerebral ventricular system in Saudi Arabia. This present work
is undertaken to study morphometric analysis of the lateral, third and fourth ventricles of the brain in normal
Saudi subjects using CT scan.
2. Materials and Methods
2.1. Selection and Description of Study Population
This study has two designs and considered as a prospective cohort as well as retrospective with referring to the
previous cases in the PACS system. The study population composed of 152 patients (89 males and 63 females)
in the age group of 3 to 81 years, attending the department of Radiology, at King Fahd Hospital from the period
of March to June 2014. The hospital was classified as one of the teaching hospital in Al medina Almunawwara.
The radiology department (CT) receives about 15 cases per day (5475 cases per year). Informed consent was
obtained from all patients for being included in the study and a previous ethical approval was obtained from the
ethical committee of the hospital. The majority of the cases were selected from the PACS system and other cases
were investigated directly with CT machine. There was no a Minimum Sample Size Calculation process before
sampling.
These patients were selected randomly and clinically confirmed no history of cerebral infarction, local mass
lesions, probable communicating hydrocephalus, alcoholism, drug abuse, trauma or previous intra-cranial sur-
gery and other hereditary diseases and were not on medication at the time of this study. CT Scans of all patients
were reported by expert radiologist scoring as normal. The CT scanner used in this study was the General elec-
tric GE (Bright speed 16 slices). The selected exposure factors were 120 kv and 435 mA, the slice thickness was
ranged between 7 to 10 mm and the noise index was 3.
2.2. Procedure of CT Scanning Technique
The patient was placed on the CT table and the head was centralized and supported for correct positioning and to
avoid blurring of images. A lateral scout image was taken to confirm correct positioning of patient and appro-
priate exposure factors. Orbito-meatal line was drawn and a line at an angle of 15 - 20 degrees to and 1 cm
above it was drawn, representing the lowest tomographic section, which passed through the base of skull. A total
of 8 to 10 axial image slices of the brain were obtained without any overlap.
2.3. Method of Measuring the Brain Ventricle
The lateral ventricles on CT are seen as two band-shaped structures with normal attenuation values. The third
ventricle is amid-line structure which is shown between the thalami and the fourth ventricle is seen as an oval
area at the center of the posterior fossa lower down, between the cerebellum and the pons. The measurements
were taken as follows:
1) Level of Fourth Ventricle
M. Gameraddin et al.
15
a) Greatest height of fourth ventricle in cm (Figure 1).
b) Greatest width of fourth ventricle in cm (Figure 1).
2) Level of Interventricular Foramen
a) Length of frontal horns of right lateral ventricle in Foramen (measured from its tip to the interventricular fo-
ramen).
b) Length of frontal horns of left lateral ventricle in cm (measured from its tip to the interventricular foramen)
can be seen in Figure 2.
3) Lateral Ventricle Measurement:
a) Length of right lateral ventricular body inclusive of level of interventricular foramen. Frontal horn (taken
from tip of frontal horn to the atrium).
b) Length of left lateral ventricular body inclusive of frontal horn (taken from tip of frontal horn to the atrium
can be seen in Figure 3.
2.4. Statistical Analysis
Data were analyzed and initially summarized as mean ± SD in a form of comparison tables. Statistical analysis
was performed using the standard Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA)
version 16 for windows. The statistical significant value was 5%, values less than 5% were considered to be sig-
nificant.
2.5. Limitations
One of the most limitations of this study, no volunteers conducted since x-rays has biological effects and ha-
zards. There were many cases had been excluded from the study due to minor pathological changes in the brain
which could influence the measurement? So, we tried as far as possible to find images with normal brain ap-
pearance.
3. Results
It was observed that the anteroposterior extent of the body of the right and left ventricles was equal in the males
(74.89 + 9.86 mm) whereas, it was larger in the right side (70.06 + 8.83 mm) than the left side (69.59 + 11.42
mm) in the females. It was also observed that mean length of the right frontal horns (27.55 + 4.175 mm) was
Figure 1. CT axial image of the brain showing the width and
height measurement of the 4th ventricle. The blue lines indi-
cate the height and the width.
M. Gameraddin et al.
16
Figure 2. CT axial image of the brain showing the length of
body of the lateral ventricles. The blue lines indicate the length
of the body of both lateral ventricles.
Figure 3. CT axial image of the brain showing the length of
the left lateral ventricle and body of right ventricle. The three
lines show the length of body of right ventricle, length of the
whole left ventricle and width of the third ventricle respec-
tively.
M. Gameraddin et al.
17
equal to the mean length of the left frontal horns (27.55 + 4.184 mm) in males and females (Table 1). It was
observed that the length of the right and left horns were equal in the males (28.53 + 3.88 mm), and were greater
than the females in the right (26.16 + 4.209 mm) and left (26.17 + 4.237 mm) as demonstrated in (Table 2). The
mean height and width of the fourth ventricle was 9.68 + 2.155 mm and 12.15 + 2.032 mm in 152 subjects
(males and females) as shown in (Table 1).
The width of fourth ventricle increases as age increases, which was statistically significant (P-value < 0.05) as
shown in (Table 3). The mean width of third ventricle was 5.57 + 1.60 in 152 subjects (males and females).
The width of third ventricle increases as age increases, which was statistically significant (P-value < 0.05) as
shown in Table 1. The measurement of the ventricles was obtained from the CT monitor using the curser as
demonstrated in Figures 1-3.
Table 1. Measurements and statistical details of lateral, third and fourth ventricles.
Table head Table column head
Total Minimum
(mm) Maximum
(mm) Mean
(mm) STD deviation
Length of body of the
right ventricle 152 46 104 72.89 9.714
Length of body of the
left ventricle 152 9 104 72.68 10.823
Length of right frontal
horn of Lateral ventricle
152 15 37 27.55 4.175
Length of left frontal
horn of lateral ventricle 152 15 37 27.55 4.184
Width of the
third ventricle 152 3 11 5.57 1.601
Height of the
fourth ventricle 152 4 19 9.68 2.155
Width of the
fourth ventricle 152 8 18 12.15 2.032
152 46 104 72.89 9.714
Table 2. Gender wise changes in the measurement and statistical details of the ventricular system.
Measurement Gender Total mean Standard deviation Significance p-value
Length of body of the right ventricle Male 89 74.89 9.860 0.002
Female 63 70.06 8.832
Length of body of the left ventricle Male 89 74.89 9.860 0.003
Female 63 69.56 11.420
width of the third ventricle Male 89 5.70 1.540 0.257
Female 63 5.40 1.680
Length of right frontal
horn of Lateral ventricle
Male 89 28.53 3.882 0.000
Female 63 26.16 4.209
Length of left frontal horn of lateral
ventricle
Male 89 28.53 3.882 0.001
Female 63 26.17 4.237
Height of the fourth ventricle Male 89 9.66 2.121 0.921
Female 63 9.70 2.219
Width of the fourth ventricle Male 89 12.54 1.901 0.005
Female 63 11.60 2.099
M. Gameraddin et al.
18
Table 3. Shows the correlation between age and width of the 4th and 3rd ventricles.
Age p-value
Width of 4th ventricle 0.410 0.000
width of the third ventricle
0.292 0.000
4. Discussion
The range of changes in the ventricular size of the brain encountered in clinical practice can lead most people to
believe that a decision taken without an exact measure of ventricular size, however, there is likely to be an in-
creasing number of circumstances in which precise measurements will be of value.
Measurements of the size of the lateral cerebral ventricles provide useful indices of cerebral asymmetry and
atrophy. The present study provides useful baseline measures on the volume of the lateral ventricle, and its va-
riability and asymmetry, in healthy subjects, and promising first steps in the task of automatic measurement of
the brain structure that is highly conspicuous but has relatively complex morphology.
According to Gomori et al., Takeda and Matsuzua, Goldestien et al. the left lateral ventricle was larger than
the right one and both were larger in the female [9]-[11]. In our study the antero-posterior extent of the right
ventricle bodies (males = 74.89 + 1.04 mm and females = 70.06 + 1.11 mm) was approximately equals to the
left ones (male = 74.89 + 1.04 mm and female 69.59 + 1.43 mm). These measures are larger than the figures
obtained by D’Souza and Natekar this may be due to the differences in age group that was larger in our study
compared to D’Souza and Natekar study which was limited between 30 and 50 years [12].
Both left and right ventricles were large in males compared to females. This is because males have heavier
and bigger skull, the capacity of the skull is 10% more compared to female skull and also because the brain size
is more in males compared to females [13].
Our study results revealed that the length of the of the right frontal horns was (28.53 + 0.41 mm) in the males
and (26.16 + 0.53 mm) in the females and that the length of the left frontal horns was equal to the right one in
the males but slightly longer than the right one in the females (26.17 + 0.53 mm). This measures was much sim-
ilar to the figures reported by D’Souza and Natekar (27.4 mm in the males and 25.5 mm in the females) for the
right frontal horns and (27.8 mm in the males and 25.8 in the females) [12].
Studies by D’Souza and Natekar revealed that the height of the fourth ventricle was 11.8 mm and 11.1 mm for
the male and female respectively. Older studies by Gawler et al. revealed that the greatest distance between the
roof and the floor of the fourth ventricle was less than 10.8 mm; however in our study this distance was signifi-
cantly smaller, (9.66 + 0.22 mm) in males and (9.70 + 0.28 mm) in the females with the mean 9.68 + 0.17 mm)
[12] [14]. In the present study, the width of the fourth ventricle was found to be greater than the height in both
genders and was more in males (12.54 + 0.20 mm) than in females 11.60 + 0.26 mm) with the mean (12.15 +
0.16).
The width of third ventricle was measured by method of radiology by various workers like Gawler J et al.,
Soininen H et al., D’souza D. & Natekar P., Meshram P. & Hattangdi S., and Duffner F. et al. [14]-[16].
Brinkman et al., Soininen et al., D’Souza et al. and Vidya K et al. found that the maximum width of the third
ventricle had a mean of 5.9 mm, 9.2 mm, 4.2 mm and 5.2 mm. In our present study, we recorded this measure
was significantly higher in males (5.70 mm) as compared to females (5.40 mm) with mean (5.57 mm) [15] [17]-
[19].
Results of this study showed that there were statistically relationships between the ages of subjects involved
in the study and the width of the third and fourth ventricles (p = 0.01) was in agreement with studies conducted
by Vidya K. et al. and D’souza D. & Natekar P. [12] [19].
5. Conclusion
The study provided useful morphometric data about the lateral, third and fourth ventricles while diagnosing vis-
ual disturbance, hydrocephalus, schizophrenia, psychotic disorders and other pathologies.
Acknowledgements
The authors would like to appreciate the role of staff of the Radiology Department at King Fahd Hospital for
M. Gameraddin et al.
19
their cooperation, help and support during data collection.
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Background: The variability of the adult lateral ventricle size may vary with gender and age. There is, however, little data on the morphology of the lateral ventricle for the Sudanese population. Objective: To measure the differences of the lateral ventricle concerning gender and age-related differences, and to establish reference values of the lateral ventricle measurements for Sudanese using computed tomography (CT). Materials and Methods: This retrospective study was conducted on 500 healthy Sudanese adults (261 male and 239 female), their ages ranged from 18 to 90 years. were collected at the CT unit of The Dar Al Elaj Specialized Hospital, Modern Diagnostic Center), Khartoum, Sudan. during the period from January 2020 to January 2021. All participants underwent brain computed tomography imaging. Shape, anteroposterior length, and area of the lateral ventricle were measured. Results: The study showed that the lateral ventricle measurement was higher in males. the left Width of the Right Lateral ventricle at p-values of 0.000, the width of the left lateral ventricle, the length of the body of the right ventricle, and the length of the body of the left ventricle no significant (with p-value 0.211, 0.545 and 0.124). Conclusion: This study showed that In conclusion, this study established baseline measurements for the lateral for the healthy Sudanese population. Furthermore, radiographically there is a slight difference in lateral ventricles measurement regarding gender.
... Moawia Gameraddin, Abdulrahim, Amir Ali & Mosleh in their study conducted in 2015 found the mean length of frontal horn in males to be 28.5mm on right and left sides, while in females it was 26.16mm and 26.17mm on right and left sides respectively. The finding of the present study was correlated well with the findings of the study conducted by Moawia et al. [8]. However, the readings obtained in Meerut on western Uttar Pradesh population of 100 male and 100 female study subjects were larger as compared to the present study. ...
... Nevertheless, it is inconsistent with the present study. This could be due to the geographical and racial distribution of the population [8]. ...
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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
... [7,8] Furthermore, due to increased evidence in changes associated with pathological conditions such as schizophrenia, tumors, trauma, alcoholism… etc., as well as gender and aging which could lead to dementia and or brain geriatric, morphological analysis of the human brain of recent has been extensively scrutinized. [9,10,11] Lastly, ventricular size measurement are crucial in the diagnosis and classification of hydrocephalus and follow-ups after ventricular shunts interventions. [12,13] This morphometric analysis of the lateral, third and fourth ventricles of the brain was undertaken among north central Nigerian adults to document reference values for the region. ...
... Measurements in millimeters (mm) were obtained at the following levels: [11] 1) Level of Interventricular Foramen The images were viewed on the computer monitor and the measurements were taken with in-built linear calipers. ...
... This is further emphasized when evaluating patients with BA. Brain tissue loss is assumed when peripheral CSF spaces are enlarged in relation to intracranial volume due to global cortical and medial temporal lobe atrophy [12], [14]. Similarly, CSF is observed larger in the intra-ventricular spaces among patients with NPH than BA and control subjects. ...
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Background: Differentiation between symptoms of normal pressure hydrocephalus (NPH) and other neurodegenerative disorders such as Brain Atrophy (BA) are usually confusing. Available diagnostic methods are invasive while the few non-invasive methods did not take care of potential factors known to influence intracranial volumes. We, therefore, aim to determine and compare the intracranial volume fractions among patients with NPH and BA. Methods: This was a prospective, cross-sectional age-matched control study among consenting patients that were diagnosed with NPH, BA and healthy control in Aminu Kano Teaching Hospital from March 2018 to November 2020. Each patient was routinely examined with CT-Scan; However, control participants were from other reasons. Participants with a medical history known to influence the intracranial volume were excluded. Volume estimation was based on a stereological Cavalieri method and three volume fractions were determined mathematically for each of the group. Test-point computing was facilitated through a locally developed software (voXas_2018). Ethical approval was sort prior to the study. Results: Patients with NPH have higher total CSF: brain ratio, intraventricular volume: brain ratio and extra-ventricular: brain ratio. Similar pattern was exhibited according to age grouping, except in the older age category where BA volume fractions were higher. Conclusion: Age, gender and statue are known to influence intracranial volumes. We controlled their potential effects through age-matched control of participants between groups and the use of intracranial volume ratios for objective diagnosis of NPH and BA. However, Tcsf:Br and InV:Br volume fraction ratios were found to be reliable indices for distinguishing patients with NPH and BA.
... 1,2 This scientific issue was addressed by many researchers recently. 3 Although the variability of the parameters of the ventricular system is extremely important, especially in the neurosurgery field, there is still a lack of the sources providing precise, unambiguous, or bias data on the subject matter. ...
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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 fourth ventricle of the brain and the shape of the skull in 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, transverse diameters, and height of the fourth 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 fourth ventricle of the brain in dolichocranial, mesocranial, and brachycranial individuals. Conclusion The morphometric parameters of the fourth ventricle of the brain, such as height, anteroposterior, and transverse diameters, depend on the individual anatomic variability of the skull shape and gender.
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The aim of this study was to determine the normal values of brain ventricles and indices in healthy subjects in our population using magnetic resonance imaging (MRI) and to reveal sex and age related differences. The MRI of two hundred-sixty-five healthy individuals aged between eighteen and eighty-seven years were examined and the midsagittal and axial images were used for measurements. The measurements were performed from MRI on a Workstation. The following mean values of brain ventricles and indices were observed; frontal horn width (FHW) (33.14 mm); third (3rd) ventricle width (TVW) (3.37 mm); fourth ventricle anteroposterior width (FVWAP) (9.93 mm); fourth ventricle transverse width (FVWT) (12.40 mm); and the maximum transverse inner diameter of the skull (TIDS) (128.75 mm) in females. The same dimensions were 34.85 mm, 3.91 mm, 10.26 mm, 12.81 mm, and 134.68 mm in males, respectively. There were statistically significantly differences in the frontal horn width, third (3rd) ventricle width, and the maximum transverse inner diameter of the skull values in between sexes. The mean values of Evans’ index which obtanied with maximum width between the frontal horns of the lateral ventricles divided by the maximum transverse inner diameter of the skull were found as 0.280 ±0.172 in females; whereas the same dimensions were calculated 0.276±0.161 in males. These values were lower in healthy male subjects than females, however; there were no found significantly difference between groups. Present findings obtained from MRI are necessary anatomical baseline data for interpreting pathological changes, planning surgery, and determining presence and progress of some neurological diseases.
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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 etiology and consistency of findings on normal sexual dimorphisms of the adult human brain are unresolved. In this study, we present a comprehensive evaluation of normal sexual dimorphisms of cortical and subcortical brain regions, using in vivo magnetic resonance imaging, in a community sample of 48 normal adults. The men and women were similar in age, education, ethnicity, socioeconomic status, general intelligence and handedness. Forty-five brain regions were assessed based on T 1 -weighted three-dimensional images acquired from a 1.5 T magnet. Sexual dimorphisms of adult brain volumes were more evident in the cortex, with women having larger volumes, relative to cerebrum size, particularly in frontal and medial paralimbic cortices. Men had larger volumes, relative to cerebrum size, in frontomedial cortex, the amygdala and hypothalamus. A permutation test showed that, compared to other brain areas assessed in this study, there was greater sexual dimorphism among brain areas that are homologous with those identified in animal studies showing greater levels of sex steroid receptors during critical periods of brain development. These findings have implications for developmental studies that would directly test hypotheses about mechanisms relating sex steroid hormones to sexual dimorphisms in humans.
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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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A new interactive computers has been developed to measure ventricular volume from CAT scans. Testing this system on phantoms demonstrated an accuracy to within 16%. Then a series of scans of patients with obstructive hydrocephalus was analyzed using both tradional linear measures and the computer method. None of the traditional measures were directly proportional to the calculated volume. The area measure of ventricular volume correlated well with the computer-generated values. Clinical studies which attempt to quantitate ventricular volume should use a computerized or planigraphic measure.
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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.
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Using computed tomography, the authors studied enlargement of the ventricles and the free spaces (cisternae and sulci) above the level of the tentorium cerebelli during aging in 97 men and 55 women with no neurologic disturbances, ranging in age from 17 to 86 years, and calculated a ventricular volume index (100% X ventricular volume/cranial cavity volume) and a free space volume index (100% X free space volume/cranial cavity volume). Both the ventricular volume and the ventricular volume index started to increase significantly in the forties in men and in the fifties in women. Both the free space volume and the free space volume index were found not to increase until the sixties in both men and women. Both the ventricular volume index and the free space volume index were smaller in hypertensives than in normotensives in men over age 65.
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This article describes a technique in which X ray transmission readings are taken through the head at a multitude of angles: from these data, absorption values of the material contained within the head are calculated on a computer and presented as a series of pictures of slices of the cranium. The system is approximately 100 times more sensitive than conventional X ray systems to such an extent that variations in soft tissues of nearly similar density can be displayed.
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To assess whether computed tomographic findings are present at the onset of schizophrenia, we evaluated CT scans of 35 patients with first-episode schizophreniform disorder, 17 with chronic schizophrenia, 23 with affective disorders, 27 with other psychiatric disorders, and 26 controls. Both the schizophreniform and the chronic schizophrenic patients had significantly larger cerebral ventricles than did the other psychiatric or control subjects. Ventricular size in the patients with affective disorder was not significantly different than in any of the other groups. Twenty percent of the schizophreniform patients had enlarged ventricles, (ventricular-brain ratio, greater than 10). The only other subjects outside this limit were four chronic schizophrenic patients (24%). Five schizophreniform patients and three with affective disorder had evidence of mild cortical atrophy. The results suggest that, in some schizophrenic patients, ventricular enlargement and less frequently cortical atrophy predate the onset of psychoses and are not a result of psychiatric treatment.