Fourth Ventricle Volume Research Articles

Third Ventricle Volume Predicts Functional Outcome in Chronic Subdural Hematoma.

There is a lack of evidence demonstrating the utility of computed tomography (CT) to predict chronic subdural hematoma (CSDH) clinical outcomes. We aim to analyze the role of tomographic volumetric analysis in patients with CSDH. We performed a retrospective study of patients undergoing burr-hole craniostomy (BHC) for CSDH over five years at a tertiary care center. Degree of midline shift, radiographic density, subdural hematoma volume, acute blood volume, and third ventricle (3VV) and fourth ventricle (4VV) volume were estimated using semiautomatic segmentation of preoperative CT. Postoperative functional outcome was measured by two endpoints: National Institute of Health Stroke Scale (NIHSS) at discharge and short-term modified Rankin Scale (mRS) at 6-week follow-up. Univariate and multivariate analyses were performed using nonparametric tests. Discriminative capacity and optimal thresholds of independent variables were calculated by means of receiving-operative curves (ROC). A total of 79 patients were included for analysis with a median age of 78.5years. Greater preoperative 3VV independently correlated with poor discharge NIHSS (p=.01) and short-term mRS (p=.03). A cutoff value of 0.545mL demonstrated the highest sensitivity (77.1%) and specificity (88.8%) with an odds ratio for an mRS functional dependence of 9.29 (p=.001). Greater preoperative tomographic 3VV independently prognosticates poor discharge NIHSS and 6-week mRS. A threshold 3VV of 0.545mL can be used to identify patients at higher risk of being dependent at first protocolized follow-up.

The effect of Gamma Knife radiosurgery on large posterior fossa metastases and the associated mass effect from peritumoral edema.

Gamma Knife radiosurgery (GKRS) as monotherapy is an option for the treatment of large (≥ 2 cm) posterior fossa brain metastases (LPFMs). However, there is concern regarding possible posttreatment increase in peritumoral edema (PTE) and associated compression of the fourth ventricle. This study evaluated the effects and safety of GKRS on tumor and PTE control in LPFM. The authors performed a single-center retrospective review of 49 patients with 51 LPFMs treated with GKRS. Patients with at least 1 clinical and radiological follow-up visit were included. Tumor, PTE, and fourth ventricle volumetric measurements were used to assess efficacy and safety. Overall survival was a secondary outcome. Fifty-one lesions in 49 consecutive patients were identified; 57.1% of patients were male. At the time of GKRS, the median age was 61.5 years, and the median Karnofsky Performance Status score was 90. The median number of LPFMs and overall brain metastases were 1 and 2, respectively. The median overall tumor, PTE, and fourth ventricle volumes at diagnosis were 4.96 cm3 (range 1.4-21.1 cm3), 14.98 cm3 (range 0.6-71.8 cm3), and 1.23 cm3 (range 0.3-3.2 cm3), respectively, and the median lesion diameter was 2.6 cm (range 2.0-5.07 cm). The median follow-up time was 7.3 months (range 1.6-57.2 months). At the first follow-up, 2 months posttreatment, the median tumor volume decreased by 58.66% (range -96.95% to +48.69%, p < 0.001), median PTE decreased by 78.10% (range -99.92% to +198.35%, p < 0.001), and the fourth ventricle increased by 24.97% (range -37.96% to +545.6%, p < 0.001). The local control rate at first follow-up was 98.1%. The median OS was 8.36 months. No patient required surgical intervention, external ventricular drainage, or shunting between treatment and first follow-up. However, 1 patient required a ventriculoperitoneal shunt at 23 months from treatment. Posttreatment, 65.30% received our general steroid taper, 6.12% received no steroids, and 28.58% required prolonged steroid treatment. In this retrospective analysis, patients with LPFMs treated with GKRS had a statistically significant posttreatment reduction in tumor size and PTE and marked opening of the fourth ventricle (all p < 0.001). This study demonstrates that GKRS is well tolerated and can be considered in the management of select cases of LPFMs, especially in patients who are poor surgical candidates.

Fourth Ventricle Enlargement in Chiari Malformation Type I

How Chiari malformation type I (CM-I) affects posterior fossa brain structures and produces various symptoms remains unclear. The fourth ventricle is surrounded by critical structures required for normal function. The foramen of Magendie can be obstructed in CM-I; therefore, fourth ventricle changes may occur. To test this hypothesis, we assessed fourth ventricle volume in CM-I compared with healthy controls. Using our database from 2007-2016, we studied 72 patients with CM-I and 30 age-matched healthy control subjects. Fourth and lateral ventricle volumes and posterior fossa volumes (PFV) were assessed and correlated with clinical signs and symptoms. Statistical analysis was performed. Patients with CM-I had larger fourth ventricle volumes compared with control subjects (1.31 vs. 0.95 mL; P= 0.012). There were no differences in lateral ventricle volume or PFV. CM-I fourth ventricle volume was associated with tonsillar descent (P= 0.030). CM-I fourth ventricle volume variance was larger than healthy controls (F71,29= 8.33; P < 0.0001). Patients with CM-I with severe signs and symptoms had a significantly larger fourth ventricle than patients with CM-I with mild signs and symptoms (1.565 vs. 1.015 mL; P= 0.0002). The fourth ventricle can be enlarged in CM-I independent of lateral ventricle size and is associated with greater tonsillar descent. Most importantly, fourth ventricle enlargement was associated with a worse clinical and radiographic presentation independent of PFV. Fourth ventricle enlargement can affect critical structures and may be a mechanism contributing to symptoms unexplained by tonsil descent. Fourth ventricle enlargement is a useful adjunct in assessing CM-I.

A Comprehensive Clinical Decision Support Application Software tool for estimate of the Fourth Ventricle volume using Brain Computed Tomography scan for Clinical Application

The physiology and anatomy of the ventricular system has become an area of research for clinicians in neuropsychiatry to help manage neurologic diseases as well as other diseases such as chronic alcoholism. The objective of this study is to develop an easy and user-friendly graphical user interface for calculating fourth ventricle volume. Materials used were Minitab statistical tool and MeVisLab modelling tool. The methodology involved the use of MeVisLab measurements tool to measure the linear and volume dimensions using Voxel Count Method. Whilst the modeling was done with Minitab statistical tool to model the relationship between the linear and volume measurements. Minitab statistical modeling tool and the written code was done with python programming language. Minitab statistical software was used to model the relationship between the fourth Ventricle Volume and the product of fourth ventricle length (VL), fourth ventricle width (VW) and fourth ventricle thickness (VT). Ten model equations were developed; five each for males and females for the age group (21-30, 31-40, 41-50, 51-60 and 61-70). A comprehensive decision support application software tool has been developed for easy, accurate and user-friendly GUI as part of diagnostic procedure for the calculation of volume of fourth ventricle to aid neurological diagnosis in clinical practice. These would help neurosurgeons in their diagnosis, localization and surgical removal of tumors and lesions (craniopharyngiomas and gliomas) surrounding the ventricular system.

Exercise-heat stress with and without water replacement alters brain structures and impairs visuomotor performance.

Effects of exercise‐heat stress with and without water replacement on brain structure and visuomotor performance were examined. Thirteen healthy adults (23.6 ± 4.2 years) completed counterbalanced 150 min trials of exercise‐heat stress (45°C, 15% RH) with water replacement (EHS) or without (~3% body mass loss; EHS‐DEH) compared to seated rest (CON). Anatomical scans and fMRI Blood‐Oxygen‐Level‐Dependent responses during a visuomotor pacing task were evaluated. Accuracy decreased (P < 0.05) despite water replacement during EHS (−8.2 ± 6.8% vs. CON) but further degraded with EHS‐DEH (−8.3 ± 6.4% vs. EHS and −16.5 ± 10.2% vs. CON). Relative to CON, EHS elicited opposing volumetric changes (P < 0.05) in brain ventricles (−5.3 ± 1.7%) and periventricular structures (cerebellum: 1.5 ± 0.8%) compared to EHS‐DEH (ventricles: 6.8 ± 3.4, cerebellum: −0.7 ± 0.7; thalamus: −2.7 ± 1.3%). Changes in plasma osmolality (EHS: −3.0 ± 2.1; EHS‐DEH: 9.3 ± 2.1 mOsm/kg) were related (P < 0.05) to thalamus (r = −0.45) and cerebellum volume (r = −0.61) which, in turn, were related (P < 0.05) to lateral (r = −0.41) and fourth ventricle volume (r = −0.67) changes, respectively; but, there were no associations (P > 0.50) between structural changes and visuomotor accuracy. EHS‐DEH increased neural activation (P < 0.05) within motor and visual areas versus EHS and CON. Brain structural changes are related to bidirectional plasma osmolality perturbations resulting from exercise‐heat stress (with and without water replacement), but do not explain visuomotor impairments. Negative impacts of exercise‐heat stress on visuomotor tasks are further exacerbated by dehydration.

The Magnetic Resonance Imaging Measurement of the Hippocampal Formation Volume of Normal Chinese Adults

The objective of this study was to measure the normal hippocampal formation of the adults in China and to provide data for the prevention and diagnoses of the related diseases. 3D-fSPGR sequence scanning was used in 68 cases of healthy adult brain to gain the image between lateral border of bilateral fourth ventricle and vitreous body. The image then was divided into 10 equal parts in the sagittal plane. We can trace the area of the hippocampal formation in each part and the data gained was analyzed by SPSS to calculate the volume. The calibrated normal adult average hippocampal formation volume on the right was 2649.92-2903.17 mm(3) while on the left was 2579.42-2803.27 mm(3). The male right average hippocampal formation volume was 2601.84-2986.44 mm(3) and the left was 2526.32-2886.94 mm(3). The female right average hippocampal formation volume was 2531.88-2819.06 mm(3) and the left was 2579.42-2803.27 mm(3). There was no obvious difference in various gender and age groups (P > 0.05), but there was a significant difference between bilateral hippocampal formation volume in middle-aged and elderly male group whether calibrated (t = 2.892, P< 0.05) or not (t = 2.924, P < 0.05). We can conclude that the hippocampal formation volume of normal Han adults has no relation to gender and age except that the bilateral fourth ventricle volume of middle-aged and elderly men were evidently different from each other.

Multidimensional Analysis of Fetal Posterior Fossa in Health and Disease

Fetal magnetic resonance imaging (MRI) is now routinely used to further investigate cerebellar malformations detected with ultrasound. However, the lack of 2D and 3D biometrics in the current literature hinders the detailed characterisation and classification of cerebellar anomalies. The main objectives of this fetal neuroimaging study were to provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Using a 1.5-T MRI scanner, 143 MR images were obtained from 79 normal control and 53 fetuses with posterior fossa abnormalities that were grouped according to the severity of diagnosis on visual MRI inspections. All quantifications were performed on volumetric datasets, and supplemental outcome information was collected from the surviving infants. Normal growth trajectories of total brain, cerebellar, vermis, pons and fourth ventricle volumes showed significant correlations with 2D measurements and increased in second-order polynomial trends across gestation (Pearson r, p < 0.05). Comparison of normal controls to five abnormal cerebellum subgroups depicted significant alterations in volumes that could not be detected exclusively with 2D analysis (MANCOVA, p < 0.05). There were 15 terminations of pregnancy, 8 neonatal deaths, and a spectrum of genetic and neurodevelopmental outcomes in the assessed 24 children with cerebellar abnormalities. The given posterior fossa biometrics enhance the delineation of normal and abnormal cerebellar phenotypes on fetal MRI and confirm the advantages of utilizing advanced neuroimaging tools in clinical fetal research.

Calculation of the Volume of Fourth Ventricle and the Length of Herniation Using the ImageJ Software in Patients with Chiari Type I malformation

Objective: The Chiari type 1 malformation is a congenital anomaly which is characterized by downward displacement of the cerebellar tonsils into the cervical spinal canal. The aim of this study was to determine the volume of fourth ventricle and the length of herniated cerebellar tonsils in patients with Chiari type I malformation and control group using ImageJ program. Material and Methods: We retrospectively investigated magnetic resonance (MR) images from 27 patients with Chiari type I malformation (patient group). We also investigated MR images from 18 subjects as a control group who underwent an MRI complaining of headaches with the results showing no cranial or intracranial pathology. The volume and length were estimated using the ImageJ program Results: The mean volumes of fourth ventricle were determined as a 1.08±0.20 cm3 and 1.01±0.27 cm3 for control group and patient group, respectively. Ventricle volumes obtained from two groups were not statistically different (p>0.05). We found that the mean length of herniation was 9.48±3.22 mm in the patient group. We did not determine any relationship between age and any of these variables (volume and length) in both groups. Conclusion: This study has shown that the volume of fourth ventricle and the length of herniated cerebellar tonsils can be measured by ImageJ program. We think that when correlated with clinical findings, these measurements may contribute to the evaluation of Chiari type I malformation cases. Key Words: Arnold-Chiari Malformation; Magnetic Resonance Imaging; Fourth Ventricle.

Brain ventricle volume correlates with effortful control in healthy young males

The neuroanatomical correlates of temperament in human have been examined extensively but not comprehensively. Most studies have focused on certain brain regions of gray and white matter, such as prefrontal cortex, amygdala, anterior cingulate cortex, etc, however, less is known about the contribution of other areas to human temperament [1-4]. Previous studies have shown that brain ventricle is related to psychiatric diseases, which exemplify problems in self-control, here we sought to explore whether the size of brain ventricle is associated with individual differences in temperament in healthy college students. Thirty-eight subjects (21 males, 17 females, age 18-23 years) were selected randomly, and scanned using a three-dimensional T1-weighted magnetization-prepared gradient echo (MPRAGE) sequence on a Siemens 3T Allegra scanner to acquire anatomic data, which were then segmented by FreeSufer and calculated for volume. Individual temperament was assessed using the Adult Temperament Questionnaire (ATQ)[5], and scores of each scale were then correlated with the ventricular volume. We found a positive correlation between the volume of fourth ventricle and effortful control (one of the four core temperament dimensions in ATQ) in males (r=0.485, p=0.026), suggesting that males with larger fourth ventricle volume, have great capacity to focus and direct attention, and inhibit inappropriate behavior. However, no significant correlation was detected in females.

Biometric analysis of fetal cerebellum

BackgroundCerebellar malformations are one of the main referral reasons for fetal magnetic resonance imaging, with recent studies suggesting associated impairments in higher cognitive functions. The lack of biometric data, motion...

Ventricular enlargement in new-onset pediatric epilepsies

To examine baseline and prospective (2-year) changes in third, fourth, and lateral ventricle volumes in children with new-onset idiopathic epilepsies and controls (age 8-18 years). Structural magnetic resonance imaging (MRI) were collected from children with idiopathic generalized epilepsy (IGE, n = 29), idiopathic localization-related epilepsy (ILRE, n = 30), and healthy controls (HCs, n = 49). Volumes of the third, fourth, and lateral ventricles were derived and compared across groups, followed by shape analyses, to identify specific regions of ventricular abnormality. Of the initial cohort, a consecutive sample of 71 children returned 2 years later for reimaging and determination of progressive changes in the ventricular system. At baseline, children with new-onset IGE had significantly larger lateral and third ventricle volumes relative to the HC group. In addition, lateral ventricle enlargement in IGE was significantly greater compared to new-onset ILRE. Shape analysis of the lateral ventricles revealed that volume expansion in IGE was selective for the anterior horn, a region surrounded by the lateral and medial frontal lobes as well as basal ganglia. These abnormalities did not progress over a 2-year interval. Abnormalities in brain development prior to onset and diagnosis of epilepsy are evident and reflected in expansion of the ventricular system, especially among children with IGE. These abnormalities appear to represent an antecedent and possibly static finding given the lack of progressive ventricular expansion over the 2-year interval following diagnosis and treatment.

339. - Cerebellar volume deficits in schizophrenia

AbnonnaJities of cerebellar Sl,cture~ have been implicaled in the neuropathology of schizophrenia. The results of in i!'{) ncuroimaging stUdies. however, are contradictory; some studies report smaller anterior vennis and larger fourth vcntricles in schizophrenics compared to controls and others report no differences. This inconsistency may be attributable, in p3rt, to imllging issues and lack of regional analysis. In this study we quantified regional cerebellar volumes in 19 mcn with DSM Ul·R diagnosis of schi1.ophrenia (age=43.4:.!::7.9 yr) and no history of alcohol dependence and 26 ageand gender-matched controls (ilge45.9: 10.0 yr) using 3D·MRI. The images were aligned in Ta· lairach coordinates and resliced using intraMructural landmarks. The cerebellar hemispheres and four regions of the vennis were outlined manually anti se~menlcll inlo gray mailer. white maller, and CSF compartments. Relative 10 controls. the schizophrenic group had significantly smaller white mailer volumcs of both hcmispheres (lcrt<.OO4. right p<.OO2) ami larger fourth ventricle volumes (p=.OOO4). The volume of the vennat region that comprised the nodulus and uvula was also significantly smaller in the patient group (total tissue p<O.02, white matter p<O.OO2). These dirferences were presellt even aner adjustment for nannal vari:ltion in head Stle or nge. The finding of founh ventricle enlargement is consistcllI with enlargement of othcr velltricular regions seen in schizophrenics. The nodulus is a part of ve~tibuloccrebo;:lIar system, which control!: eye movements and ballmce and may contribute to the eye·movement abnormalilil!s observed in schizophrenia. Supponcll by MH 30854. Dl.:partment of Veleruns Affairs