Ventricular Brain Ratio Research Articles

Dialysis adequacy and hemoglobin levels predict cerebral atrophy in maintenance-hemodialysis patients

The pathogenesis of cerebral atrophy (CA) is not clear. Previous studies show a high incidence of preterm CA in hemodialysis patients. This study aims to investigate the factors influencing CA and to derive a CA prediction nomogram in maintenance-hemodialysis patients. First, brain volumes of hemodialysis patients (≤55 years) were compared against age- and sex-matched healthy controls, and differences were revealed in bilateral insular cisterns width, maximum cerebral sulci width, Evans index, ventricular-brain ratio, frontal atrophy index, and temporal lobe ratio. Then, the patients were divided equally into “no or mild” or “severe” CA groups. Potential factors influencing CA were screened. Kt/V (urea removal index) and hemoglobin levels negatively correlated with CA degree, and were used to establish a nomogram within randomly assigned training and validation patient groups. The areas under the receiver operating characteristic curves (AUROC) for training and validation groups were 0.703 and 0.744, respectively. When potassium and calcium were added to the nomogram, the AUROC for training/validation group increased to 0.748/0.806. The nomogram had optimal AUROC for training (0.759) and validation (0.804) groups when albumin was also included. Hemodialysis patients showed reduced anterior brain volumes and the nomogram established herein may have predictive value for developing CA.

Neuroimaging risk factors for participation restriction after acute ischemic stroke: 1-year follow-up study

The aim of the present study was to determine the neuroimaging predictors of poor participation after acute ischemic stroke. A total of 443 patients who had acute ischemic stroke were...

The most useful cranial ultrasound predictor of neurodevelopmental outcome at 2 years for preterm infants

To determine the most important cranial ultrasound predictors of abnormality associated with neurodevelopmental outcome at 2 years of age in preterm infants. A total of 343 preterm infants born between 2005 and 2010 and cared for in KK Women's and Children's Hospital, a tertiary paediatric hospital, with birth weight ≤1,250 g were assessed in this retrospective study. Serial cranial ultrasound examinations were examined for intraventricular haemorrhage and cystic periventricular leukomalacia. Ventricular-brain ratio on term equivalent cranial ultrasound was measured. Neurodevelopmental outcome was assessed by the performance on Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) at 2 years corrected age. Mental delay was defined as having a combined Bayley-III score (the average of cognitive and language scores) <80. The mean cognitive, language, and motor scores on Bayley-III in this cohort were 93±15, 83±18, and 92±15, respectively. Twenty-six percent of the preterm infants had mental delay and 4% had cerebral palsy. Ventricular-brain ratio >0.35 was the most significant factor associated with mental delay (odds ratio 5.28, 95% CI: 1.49-18.71, p=0.01). Other significant risk factors for mental delay were male gender, postnatal steroids, and necrotising enterocolitis, whereas maternal tertiary education was a protective factor against adverse outcome. Ventricular-brain ratio >0.35 on term-equivalent cranial ultrasound in preterm infants is the strongest predictor for mental delay on Bayley score at 2 years of age.

MORPHOFUNCTIONAL EVALUATION OF THYMUS IN PEKIN DUCK DURING DIETARY INCORPORATION OF ORGANIC SELENIUM FEED ADDITIVE DAFS-25k

The histological study results of the thymus structure of Pekin ducks during administration of DAFS-25k feed additive are presented. It has been established that the thymus is a morphologically mature and actively functioning organ in one-day-old Pekin ducklings. With age an increase in the size of thymus lobules was observed in ducklings in the control and experimental groups but under the influence of selenium the cortical area increased more intensively. 45-day-old ducklings in the experimental group demonstrated a reliable increase in the ventricular-brain ratio mainly due to the expansion of the cortical area. The surface of the cortical substance did not change in intact ducklings, the tendency of extension in the surface of the brain substance was observed, which at that age is a sign of an accidental involution associated with the onset of a plumage change from juvenile down to primary feathers. Under the influence of selenium in the thymus of the ducklings of the experimental group the processes of accidental involution are leveled, the processes of synthesis of thymopoietins and proliferation of thymocytes are more active. Up to age of 75 days there is active proliferation of thymocytes in the thymus of ducklings of both groups; however reliably higher parameters of ventricularbrain ratio under the influence of selenium were observed in the experimental group, there was a clear boundary between them, as well as significantly higher quantity and size parameters of Hassal’s corpuscles were noted. From the age of 90 days signs of age involution in the organ were observed, and in the experimental group these processes were going more physiologically in accordance with the age of the birds. Introduction of the organic and selenium additive DAFS-25k in the diet of ducklings at a dose of 1.3 mg/kg of feed promoted the increase of the functional activity of the thymus that leveled the development of accidental involution and optimization of age involution.

S75. Polysomnographic parameters and their computed tomography brain morphology correlates in depression

Introduction Sleep in depression is characterized by a reduction of slow wave sleep (SWS) and shortening of the interval between sleep onset and the occurrence of the first REM period (i.e. REM latency). In this study, the authors sought to study and compare the polysomnographic patterns in patients with major depressive disorder and their first degree relatives and also to establish any correlation between sleep parameters and brain ventricular system measurements in patients with depression. Methods In this study, patients (N = 15) with ICD-10 clinical diagnosis of unipolar depression (N = 7) or recurrent depressive disorder (N = 8) along with their first degree male relatives (N = 15) and normal controls (N = 15) were enrolled. All the participants underwent two nights of polysomnography. The polysomnographic data was collected and analyzed using the Sandman Elite Polysomnography System. Computed Tomography was used for neuroimaging of brain. Results Significant difference was observed between the three groups in terms of total sleep period, sleep onset latency, stage 1 latency, REM duration, REM percentage of total sleep time and REM latency. Ventricular brain ratio (VBR) was found to be significantly more in the patient group (7.26 ± 1.55) and Bicaudate ratio (BCR) showed significantly more in patients group (0.140 ± 0.047). Bifrontal ratio was also observed to be significantly more in the patient group. Conclusion This study failed to find any correlation between polysomnographic parameters and ventricular dysmorphology.

Progressive Brain Atrophy in Super-refractory Status Epilepticus.

Prolonged seizures in super-refractory status epilepticus (SRSE) have been shown to cause neuronal death and reorganization, and visual inspection in individual case studies has demonstrated progressive cortical and subcortical atrophy. At present, magnetic resonance imaging (MRI) studies that evaluate brain atrophy in SRSE are lacking. To document and quantify the development of atrophy over time in SRSE. This retrospective medical record review included all patients with SRSE who were admitted to a tertiary referral campus of the Mayo Clinic Hospital with SRSE from January 1, 2001, to December 31, 2013. Patients with (1) an initial MRI scan performed within 2 weeks of SRSE onset, (2) a second MRI scan within 6 months of SRSE resolution, and (3) a minimum duration of 1 week between MRI scans were included. The ventricular brain ratio (VBR) was measured on T2-weighted fluid-attenuated inversion recovery (FLAIR) images at disease onset and during follow-up. Measurements were performed on axial FLAIR images with section thickness of less than 5 mm. The plane immediately superior to the caudate head was chosen for analysis. The hypothesis that atrophy develops during SRSE despite seizure control (electroencephalogram background suppression with anesthetic drugs) was tested. Data were analyzed from June 1 to December 31, 2015. Change in VBR (ΔVBR) as a percentage of the starting measure. Nineteen patients met the inclusion criteria; these included 10 men (53%) and 9 women (47%) with a median age of 41 (interquartile range [IQR], 25-68) years. Anesthetic agents were required for a median of 13 (IQR, 5-37) days. Initial MRI was performed a median of 2 (IQR, 1-7.5) days from the onset of SRSE, and the second MRI was performed a median of 11 (IQR, 5-15.5) days from the resolution of SRSE, with a median of 40 (IQR, 15-65) days between MRI scans. Median ΔVBR was 23.3% (IQR, 10.5%-70.3%). A significant correlation between the duration of anesthetic agent use and ΔVBR was found (Spearman r = 0.54; P = .02). Atrophy developed in all patients with SRSE who underwent serial imaging, despite administration of agents for seizure control. The degree of atrophy appears to be related to the duration of SRSE.

The relationship between ventricular size at 1 month and outcome at 2 years in infants less than 30 weeks’ gestation

BackgroundCranial ultrasound cerebral biometric measurements have been used in preterm neonates, particularly in cases of ventriculomegaly. While cerebral biometric measures using MRI have been found to correlate with long-term outcome,...

Study factors influencing ventricular enlargement in schizophrenia: A 20year follow-up meta-analysis

A meta-analysis was performed on studies employing the ventricular-brain ratio to compare schizophrenic subjects to that of normal controls. This was a follow-up to a similar meta-analysis published in 1992 in which study-, in addition to clinical-, factors were found to contribute significantly to the reported difference between patients with schizophrenia and controls. Seventy-two (N=72) total studies were identified from the peer reviewed literature, 39 from the original meta-analysis, and 33 additional studies published since which met strict criteria for inclusion and analysis - thus representing ~30 years of schizophrenia ventricular enlargement research. Sample characteristics from schizophrenics and controls were coded for use as predictor variables against within sample VBR values as well as for between sample VBR differences. Additionally, a number of factors concerning how the studies were conducted and reported were also coded. Obtained data was subjected to unweighted univariate as well as multiple regression analyses. In particular, results indicated significant differences between schizophrenics and controls in ventricular size but also the influence of the diagnostic criteria used to define schizophrenia on the magnitude of the reported VBR. This suggests that differing factors of the diagnostic criteria may be sensitive to ventricular enlargement and might be worthy of further examination. Interestingly, we observed an inverse relationship between VBR difference and the number of co-authors on the study. This latter finding suggests that larger research groups report smaller VBR differences and may be more conservative or exacting in their research methodology. Analyses weighted by sample size provided identical conclusions. The effects of study factors such as these are helpful for understanding the variation in the size of the reported differences in VBR between patients and controls as well as for understanding the evolution of research on complex clinical syndromes employing neuroimaging morphometrics.

Ventricular dilatation in relation to outcome at 2 years of age in very preterm infants: a prospective Finnish cohort study

The aim of this study was to analyse the relation between ventricular dilatation at term and neurodevelopmental outcome at 2 years corrected age in infants of very low birthweight (VLBW) or very low gestational age (VLGA). A total of 225 VLBW or VLGA infants (121 males, 104 female; mean birthweight 1133 g, SD 333 g; mean gestational age 29 wks, SD 2 wks 5d) born in Turku University Hospital were included. Ventricular-brain ratio and the widths of each lateral ventricular horn were determined using ultrasonography, and the volume of the ventricles was measured by magnetic resonance imaging at term. The 2-year outcome measures included scores for the Hammersmith Infant Neurological Examination, the presence of cerebral palsy (CP), the Mental Developmental Index (MDI) of the Bayley Scales of Infant Development (2nd edition), and the presence of severe hearing or vision impairments or any neurodevelopmental impairment (NDI). CP was diagnosed in 15 participants (6.7%) and severe hearing deficit in 12 participants (5.3%). No severe vision impairment was found. Mild and severe cognitive delay was found in 24 (10.7%) and 8 (3.6%) of the VLBW or VLGA infants respectively. Isolated ventricular dilatation did not increase the risk for developmental impairments. However, ventricular dilatation with additional brain pathology was significantly associated with CP, MDI score below 70, and NDI. A ventricular-brain ratio above 0.35 was a sensitive measure of developmental impairment. Ventricular dilatation at term increases the risk of poor developmental outcome only when associated with other brain pathology. The ventricular-brain ratio is a useful clinical tool for determining the prognosis in VLBW and VLGA infants.

Brain size and brain/intracranial volume ratio in major mental illness

BackgroundThis paper summarizes the findings of a long term study addressing the question of how several brain volume measure are related to three major mental illnesses in a Colorado subject group. It reports results obtained from a large N, collected and analyzed by the same laboratory over a multiyear period, with visually guided MRI segmentation being the primary initial analytic tool.MethodsIntracerebral volume (ICV), total brain volume (TBV), ventricular volume (VV), ventricular/brain ratio (VBR), and TBV/ICV ratios were calculated from a total of 224 subject MRIs collected over a period of 13 years. Subject groups included controls (C, N = 89), and patients with schizophrenia (SZ, N = 58), bipolar disorder (BD, N = 51), and schizoaffective disorder (SAD, N = 26).ResultsICV, TBV, and VV measures compared favorably with values obtained by other research groups, but in this study did not differ significantly between groups. TBV/ICV ratios were significantly decreased, and VBR increased, in the SZ and BD groups compared to the C group. The SAD group did not differ from C on any measure.ConclusionsIn this study TBV/ICV and VBR ratios separated SZ and BD patients from controls. Of interest however, SAD patients did not differ from controls on these measures. The findings suggest that the gross measure of TBV may not reliably differ in the major mental illnesses to a degree useful in diagnosis, likely due to the intrinsic variability of the measures in question; the differences in VBR appear more robust across studies. Differences in some of these findings compared to earlier reports from several laboratories finding significant differences between groups in VV and TBV may relate to phenomenological drift, differences in analytic techniques, and possibly the "file drawer problem".

Brain and Ventricles in Very Low Birth Weight Infants at Term: A Comparison Among Head Circumference, Ultrasound, and Magnetic Resonance Imaging

The aim of this study was to assess the relationship among the size of the lateral ventricles, head-circumference measure, and brain volumes. In addition, the association between ventricular dilatation and various brain lesions was defined. A total of 257 preterm very low birth weight (< or =1500 g) infants who met the inclusion criteria were born in Turku University Central Hospital between 2001 and 2006. A total of 209 (84.8%) of 218 survivors participated in the study. The measurements at term included the ventricular brain ratio, the widths of the frontal and occipital horns of the lateral ventricles by ultrasound, total and regional brain volumes by MRI, and head circumference. Brain lesions were defined by ultrasound at 3 to 5, 7 to 10, and 30 days of age monthly until discharge and by MRI and ultrasound at term. An abnormal ventricular brain ratio (>0.35), an increasing number of dilated ventricular horns, and smaller head circumference were significantly associated with smaller total brain tissue volume. The abnormal ventricular brain ratio and the increasing number of dilated ventricular horns in ultrasound associated with larger ventricular volumes in MRI, and a smaller head circumference was associated significantly with reduced regional brain tissue volumes. Brain lesions were more common in infants with ventriculomegaly. The ventricular brain ratio, widths of the lateral ventricular horns, and head circumference are appropriate measures for the estimation of both total and regional brain tissue volumes. Ventriculomegaly is strongly associated with brain lesions.

Prognosis in infantile hydrocephalus

Twenty-six patients with infantile hydrocephalus were re-examined at ages ranging from 21-32 years. Operations had been performed in 11, but abnormal head growth continued post-operatively in 9. One third of the patients lead a normal life, while half of the patients are mentally deficient. All patients have neurological signs, poor dexterity and clumsiness being present in all. Psychological testing reveals uneven profiles, in 4 patients with performance IQ considerably lower than verbal IQ. Computerised tomography demonstrates all degrees of hydrocephalus with no correlation between ventricular-brain ratio and IQ or between ventricular-brain ratio and operative procedures. Full otoneurological investigation shows differential-caloric examination to be abnormal in 60%, although none of the patients have complaints referring to the vestibular system.

Pathoanatomy of schizophrenia.

Schizophrenia is related to physiological and anatomical disorders in the brain (Andreasen, Flaum, Swayze, Tyrell, & Arndt, 1990; Andreasen, 1985; Crow, 1980). Physiological changes are more closely associated with positive symptoms, while anatomical changes are more closely linked to negative symptoms. Physiological alterations thought to contribute to schizophrenia include increased levels of subcortical dopamine (i.e., the dopamine hypothesis proposed by Matthysse [1977]) and reductions in glucose utilization and central amine activity (Rao & Moller, 1994). A future column will address the neurophysiology and neurochemistry of schizophrenia. Many anatomical changes occurring in schizophrenia are microscopic. An exception is the ventricular enlargement (or increased ventricular brain ratios [VBRs]) found in patients with chronic schizophrenia (Andreasen, 1985; Flaum et al., 1995; Lewine, Hudgins, Brown, Caudle, Risch, 1985; Rao & Moller, 1994; Vita et al., 1994, 1995). This observation first grew out of postmortem findings that suggested a significant increase in ventricular size among schizophrenic patients. CT and now MRI studies confirm these earlier reports. Ventricular enlargement has two etiologies: 1) ventricles expand like a balloon due to increased levels of cerebrospinal fluid and 2) ventricles fill a vacuum when periventricular tissue dies, atrophies, or does not fully develop. The former occurs in hydrocephalus while the latter is prominent in Alzheimer's disease (cell death and atrophy) and in schizophrenia (developmental lag). It is important to note that unlike Alzheimer's disease, the ventricular enlargement found among schizophrenic patients is not thought to be associated with neurodegeneration (Marsh, Suddath, Higgins, & Weinberger, 1994; Roberts, Leigh, & Weinberger, 1993; Sponheim, Iacono, & Beiser, 1991). The photograph on the left in Figure 1 is that of a sized ventricle in a person not afflicted with schizophrenia. The photograph on the right shows the enlarged ventricles of a person suffering from schizophrenia. The difference in ventricular size is readily apparent in these photographs but not all cases are so compelling because approximately 50 percent of schizophrenia patients fall within the range of control or normal subjects (Cannon & Marco, 1994). The search for a gross anatomical marker of schizophrenia is further compromised by ventricular variability; that is, ventricle size varies among nonschizophrenic individuals as well. Historically then, finding acceptable control ventricles has been a major challenge to schizophrenia researchers. [Figure 1 ILLUSTRATION OMITTED] The search for adequate controls has led researchers to what might be the control-the monozygotic, unaffected twin of patients with schizophrenia. As a group, first-degree relatives have a high (70% to 100%) sensitivity ratio for ventricular enlargement (Cannon & Marco, 1994), and it is consistent with genetic theory to assume monozygotic twins occupy the higher end of this range. As can be seen in Figure 2, the affected twin has a slightly larger ventricle than does the unaffected twin. However, without the perfect control, the schizo-phrenic twin would not present with a discernably larger ventricle. In fact, when compared to the affected patient in Figure 1, the affected twin in Figure 2 would appear to be well within the parameters of ventricular size. Compositely, Figures 1 and 2 suggest a continuous distribution of pathology (from seemingly slight to gross pathoanatomical changes) among individuals with schizophrenia. Hence, even small losses of periventricular brain tissue can have profound impact on mental function. [Figure 2 ILLUSTRATION OMITTED] Other anatomical changes are microscopic but aggregately can manifest in such proportion as to be visible to the unaided eye. A majority of studies find schizophrenia patients, as a group, have significantly smaller limbic structures (Marsh et al. …

Intracranial (structural) changes in obsessive- compulsive disorder: A computerized tomography scan study

Objective:To assess intracranial structural changes in obsessive-compulsive disorder (OCD) with CT scan.Materials and Methods:Thirty patients of OCD between 21 and 40 years of age and fulfilling various inclusion and exclusion criteria were compared with control group. CT scans of all the patients and controls were taken and compared with regard to ventricular size, Evan’s ratio and ventricular brain ratio (VBR).Results:Patients of OCD were found to have greater cortical atrophy and scored significantly higher in frontal and parietal area. Only 4 patients had enlarged ventricles, and there were none with a smaller ventricle. Mean Evan’s ratio of patients was lower than that of the control group but the difference was statistically nonsignificant. The mean VBR of patients was lower than that of the control group and the difference was highly significant.Conclusions:The evidence of neuro-radiological abnormalities in patients with OCD suggests that these disorders should not be considered merely functional in the traditional sense.

P.3.a.028 Gender difference in clinical and cognitive neuropsychiatric characteristics of schizophrenic patients

A comprehensive assessment of computed tomography (CT) with respect to clinical, historical and neuropsychological variables has been carried out in a sample of DSM III schizophrenics fairly heterogenous with respect to duration and severity of illness and in a normal control group matched for sex, age and educational level.The mean value of ventricular brain ratio (VBR) was significantly higher in schizophrenics than controls. Seven patients (21.2%) who had VBRs exceeding 2 SD of the control mean showed a significantly longer duration of illness than the other schizophrenics with significantly higher scores on the subscales alogia, effective flattening and attentional impairment of SANS, on the scales self-care and behaviour in crises and emergencies of DAS, on the scales rhythm, tactile, visual, reading, arithmetic, memory and left hemisphere of LNNB, and on the subtests arithmetic, digit span, digit symbol and block design of WAIS.These results confirm earlier reports of an enlargement of lateral cerebral ventricles in a subset of schizophrenics, and its association with a higher degree of cognitive and neuropsychological impairment, social maladjustment and defectual symptomatology. Moreover, they suggest that the neuropathological process likely to underlie the increase of cerebral ventricular size progresses during the course of the illness rather than predating its onset.

Long‐term effects of striatal lesions on c‐Fos immunoreactivity in the pedunculopontine nucleus

The basal ganglia are a group of subcortical nuclei classically thought to be involved in the control of movement, and they have reciprocal connections with the cortex, thalamus and structures in the brainstem. Recent findings suggest that the basal ganglia interact with structures involved in the control of the sleep-waking cycle. The pedunculopontine tegmental nucleus (PPN) maintains a close relationship with the basal ganglia and is intimately involved in the regulation of wakefulness and REM sleep. This study evaluated changes in activity of PPN neurons following striatal kainic acid-induced lesions. Rats were injected in the anterodorsal striatum with either kainic acid or vehicle and allowed to recover for 7 or 30 days. The results showed an increase in the number of c-Fos+ cells in the PPN 30 days but not 7 days after the striatal lesion, when motor hyperactivity was no longer detected. In addition, we found a significant correlation between the ventricular brain ratio, as an indicator of lesion size, and the number of c-Fos+ cells in the PPN. Furthermore, the spatial distribution of cell types suggested that most c-Fos+ cells in the PPN were not cholinergic. These results provide new insights into the functional relationship between the basal ganglia and the PPN and suggest that the striatum, through its indirect influence on the PPN, may contribute to the regulation of wakefulness and cortical activation.

Correlation between P300 and EEG rhythm in schizophrenia.

We hypothesized that cognitive deficits reflected by P300 abnormality and distorted EEG rhythm in schizophrenia, which might share the subcortical generation system, could be closely associated with each other. Our goal is to assess the relationship between P300 and EEG rhythm generation in schizophrenics. Quantitative EEG (QEEG) in resting condition and P300 during auditory oddball paradigm were recorded with 25 unmedicated patients. Additionally, lateral ventricular-brain ratio (LV-BR), which partially reflects thalamic volume, was measured using CT scan. Brief Psychotic Rating Scale (BPRS) and Scale for Assessment of Negative Symptoms (SANS) were also rated. P300 amplitudes at Pz positively correlated with theta and slow alpha power before pharmacotherapy, however, the correlation tended to be confined to fast alpha after pharmacotherapy. BPRS and SANS showed no significant correlation with QEEG. High frequency bands such as fast alpha and beta showed trends to correlate negatively to LV-BR. The lack of correlation between P300 amplitudes and fast alpha power before pharmacotherapy, which was restored after pharmacotherapy, might indicate thalamocortical dysfunction in schizophrenia.

Dialysis-Related Hypotension as a Cause of Progressive Frontal Lobe Atrophy in Chronic Hemodialysis Patients: A 3-Year Prospective Study

Background/Aim: Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD. Methods: By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area). Frontal brain atrophy was assessed by the frontal atrophy index (FAI; frontal brain area/intracranial frontal space). The number of lacunae was also counted. We studied 32 HD patients without symptomatic neurological abnormalities or diabetes mellitus: male/female ratio 19/13; mean age ± SD 53 ± 10 (range 28–77) years; mean HD duration ± SD 11 ± 6 (range 1–22) years. Magnetic resonance imagings were taken in 1995 and 1998. All dialysis-related hypotension episodes during the same period were identified from the medical records and counted. Results: The VBR ranged from 8.8 to 18.7% in 1995 (12.8 ± 2.2%) and was not different in 1998 (13.1 ± 2.7%). However, the VBR increased by more than 5% in 14 patients, and their HD duration of 13 ± 6 years was significantly longer than that of 18 patients with stable VBR (p < 0.05). The FAI in 1995 was 62.2 ± 4.2% (range 55.8–71.3%) and decreased significantly to 59.7 ± 4.7% (range 50.2–70.9%) in 1998 (p < 0.05). The change in FAI correlated significantly with both the total number of dialysis-related hypotension episodes (r = 0.45, p < 0.05) and the increase in number of lacunae (r = 0.42, p < 0.05). Conclusion: Our results suggest that dialysis-related hypotension plays a role in progressive frontal lobe atrophy in HD patients.

Association between minor physical anomalies and lateral ventricular enlargement in childhood and adolescent onset schizophrenia.

The primary purpose of this study was to investigate the association between morphological abnormalities of brain and minor physical anomalies (MPAs) in childhood and adolescent onset schizophrenia. Twenty-seven patients who had been diagnosed with schizophrenia according to DSM-IV criteria before 18 years of age were included in the study. MPAs were evaluated with the modified version of Waldrop scale (WS) by Green et al. Morphological abnormalities of brain was evaluated with ventricular-brain ratio (VBR) by using cerebral magnetic resonance imaging (MRI) examination. A significant positive correlation was observed between WS scores and VBRs. This result indicates a relationship between MPAs and lateral ventricular enlargement, and supports neurodevelopmental etiology in childhood or adolescent onset schizophrenia.

Frontal and Occipital Horn Width Ratio for the Evaluation of Small and Asymmetrical Ventricles

The aim of this study was the introduction of a new linear ventricular measurement which has a better correlation with ventricular volume than the commonly used linear measurements, especially in chronically shunted patients with small and/or asymmetrical ventricles. Ventricular volume, brain volume, Evans ratio, Schierman index, cella media index and frontal and occipital horn ratio were measured from CT scans of 57 shunted hydrocephalic patients and 20 normal control children. Four groups of patients were identified with regards to the ventricular size and symmetry (small, large, symmetrical and asymmetrical). A new linear measurement was defined as half of the ratio of the frontal and occipital ventricular width to that of the skull (frontal and occipital horn width ratio; FOHWR) and compared to other linear measurements in different patient groups. FOHWR showed better correlation with ventricular size and ventricular brain ratio than the ventricular linear measurements currently in use, especially in chronically shunted patients with small and/or asymmetrical ventricles.