Horn Width Research Articles

Normative values for Evan's index on CT scan for apparently healthy individuals

IntroductionLimited data are available from India that describe the normative volume and size of ventricular system. We add our experience with normative values of Evan's index to measure the ventricular size on CT scan in apparently healthy individuals. MethodsA total of 326 patients were included in the study, in whom brain CT scan was performed for various indications and it was apparently normal. Evan's index ratio was obtained by measuring maximum frontal horn width to the maximum transverse diameter of the inner table in the same section. The data entry and statistical analysis were done using StatsDirect® version-3. Data were expressed as mean, standard deviation, actual numbers, and percentages. ResultsWe divided the Evan's index into two categories, <0.3 and >0.3, which indicates ventriculomegaly to find out % of abnormality. The mean Evan's index in these patients was 0.25±0.02. There was no trend in Evan's index with increasing age. It was appreciated that there was not much variation in calculation of Evan's index from CT scan. It was found that Evan's index could be calculated fairly accurately by multiple observers, which could be appreciated in the form of very small standard deviations. DiscussionIn summary, the normative values of Evan's index in a group of persons were similar to as described in literature. Less than 5% of patients were having ventriculomegaly but there were no clinical symptoms related to ventriculomegaly.

Особливості циркумвентрикулярної системи головного мозку в осіб літнього віку

&lt;p&gt;Резюме. У ході морфометричного дослідження магнітно-резонансних томограм дано комплексну прижиттєву характеристику вентрикулярної системи головного мозку людини літнього віку. Вивчені гендерні особливості та міжпівкульна асиметрія відповідних показників.&lt;/p&gt;Ключові слова: вентрикулярна система, літній вік, чоловіки, жінки, МРТ, морфометрія.

Birth weight-related percentiles of brain ventricular system as a tool for assessment of posthemorrhagic hydrocephalus and ventricular enlargement.

Besides remarkable improvements of neonatal medical therapy, neurological morbidity remains a major concern in preterm infants. In particular, intracranial hemorrhage is a severe complication strongly correlated to poor neurological outcome. For early clinical assessment of intracranial hemorrhage and its impact on the ventricular system, cranial sonography is an important bedside diagnostic tool. Reference values of ventricular sizes are available in relation to gestational age (GA). So far, it has not been demonstrated that ventricular size values are also reliable in relation to birth weight (BW). In this study, we performed cranial ultrasonography in 250 preterm and term newborn infants. Measurements of the intracranial ventricular system by cranial ultrasound examination were performed within 72 h after birth. We determined ventricular index, anterior horn width, width of the third ventricle, width and length of the fourth ventricle for statistical analysis in relation to BW and GA. GA ranged from 23 weeks, 3 days to 42 weeks, 1 day (mean: 33 weeks), BW ranged from 345 to 5620 g (mean: 2146 g). Ventricular index and fourth ventricle width revealed a significant correlation to birth weight with r=0.75, each. A significant correlation to birth weight was also obtained for width and length of the third ventricle (r=0.55 and 0.47, respectively). Correlations obtained for ventricular measures in relation to GA were similar to those referring to BW. In preterm and term infants, ventricular sizes in relation to BW seem reliable for assessment and monitoring of ventricular pathologies, i.e. after intracranial hemorrhage.

Feasibility of radiological markers in idiopathic normal pressure hydrocephalus.

Various radiological markers have been proposed for diagnostics in idiopathic normal pressure hydrocephalus (iNPH). We examined the usefulness of radiological markers in the diagnostics and prediction of shunt response in iNPH. In this retrospective cohort study, we evaluated brain CT or MRI scans of 390 patients with suspected iNPH. Based on a 24-h intraventricular pressure monitoring session, patients were classified into a non-NPH (n = 161) or probable iNPH (n = 229) group. Volumes of cerebrospinal fluid compartments (lateral ventricles, sylvian and suprasylvian subarachnoid spaces and basal cisterns) were visually assessed. Disproportionally enlarged subarachnoid spaces, flow void, white matter changes, medial temporal lobe atrophy and focally dilated sulci were evaluated. Moreover, we measured quantitative markers: Evans' index (EI), the modified cella media index, mean width of the temporal horns and callosal angle. iNPH was more likely in patients with severe volumetric disproportion between the suprasylvian and sylvian subarachnoid spaces than in those without disproportion (OR 7.5, CI 95 % 4.0-14.1, P < 0.0001). Mild disproportion (OR 2.6, CI 95 % 1.4-4.6, P = 0.001) and narrow temporal horns (OR per 1 mm 0.91, CI 95 % 0.84-0.98, P = 0.014) were also associated with an iNPH diagnosis. Other radiological markers had little association with the iNPH diagnosis in the final combined multivariate model. Interestingly, EI was higher in non-NPH than iNPH patients (0.40 vs. 0.38, P = 0.039). Preoperative radiological markers were not associated with shunt response. Visually evaluated disproportion was the most useful radiological marker in iNPH diagnostics. Narrower temporal horns also supported an iNPH diagnosis, possibly since atrophy was more pronounced in the non-NPH than iNPH group.

Stented endoscopic third ventriculostomy—indications and results.

In patients with risk of reclosure of a performed opening in the floor of the third ventricle, a stented endoscopic third ventriculostomy (sETV) was performed to maintain continuous cerebrospinal fluid (CSF) diversion in patients with occlusive hydrocephalus. A retrospective analysis of a patient series is presented. A cohort of nine patients (median age 12 years and 9 months; range 1 month to 25 years and 9 months) was studied retrospectively. Etiology of hydrocephalus was aqueduct stenosis due to tumorous occlusion and tumorous infiltration of the third ventricular floor in seven of nine patients. For two patients with simple aqueductal stenosis, a sETV was performed because of young age of 1 month in one and because of previous ETV failure in the other. Correct placement of the implanted stent was demonstrated in all treated patients. There was no operative morbidity after the performed sETV. Resolution or improvement of symptoms was achieved in eight of nine patients (88.9%), and failure to control clinical symptoms was observed in one patient (11.1%), who needed subsequent shunt insertion. Decreased ventricular dimensions were seen after the sETV procedure. The median fronto-occipital horn ratio (FOHR) decreased from 0.46 (range 0.43-0.58) to 0.45 (range 0.37 to 0.59) after a median of 3 months and to a median of 0.40 (range 0.30 to 0.50) after 17 months. The median fronto-occipital horn width ratio FOHWR decreased from 0.31 (range 0.22 to 0.52) to 0.28 (range 0.14 to 0.52, p = 0.06) after a median of 3 months and to a median of 0.21 (range 0.09 to 0.36, p < 0.05). sETV is a feasible and safe alternative procedure which when performed with an appropriate trajectory allows treatment of occlusive hydrocephalus with altered anatomy of the third ventricular floor. sETV has been demonstrated to resolve or improve clinical and radiological signs of disturbed CSF circulation.

Macroscopic and microscopic evaluation of Eurasian lynx (Lynx lynx) female tubular reproductive organs in relation to ovarian structures

Although monitoring wild animals in the field is essential for estimations of population size and development, there are pitfalls associated with field monitoring. In addition, some detailed data about reproductive physiology can be difficult to obtain in wild live animals. Studying reproductive organs from the Eurasian lynx killed at hunting or found dead could be used as a valuable addition to other field data. We evaluated reproductive organs from 39 Eurasian lynx females (Lynx lynx) killed in Sweden during the hunting seasons in 2009, 2010, and 2011. According to notes on ovarian structures, the animals were categorized as being in one of four different reproductive stages: juvenile (n = 10), follicular stage (n = 8), luteal stage (n = 11), and anestrus (n = 10). Corpora lutea were classified as fresh CL from the present season or as luteal bodies from previous cycles. Microscopic evaluations were blindly coded while the outer measurements of the vagina and uterus were taken at the time of organ retrieval. The width of the endometrium, myometrium, outer width of the uterine horns, and the diameter of the vagina differed significantly with the reproductive stage (P < 0.001) and were largest in the follicular and luteal phases. The number of endometrial glands evaluated blindly coded on a subjective scale was significantly associated with the reproductive stage (P < 0.0001) and was significantly higher in the luteal phase than that in any other reproductive stages (P < 0.05). Cornification of the vaginal epithelium was only observed in females in the follicular stage or in females with signs of a recent ovulation. In conclusion, both macroscopic and histologic measurements are useful for a correct classification of the reproductive stage when evaluating reproductive organs in the Eurasian lynx killed during the hunting season. Routine evaluation of reproductive organs has a potential to be a useful additional tool to field studies of live lynx to monitor their reproduction.

Simple and reproducible linear measurements to determine ventricular enlargement in adults.

Background:Recent studies have suggested that Evan's Index (EI) is not accurate and instead endorse volumetric measurements. Our aim was to evaluate the reproducibility of linear measurements and their correlation to ventricular volume.Methods:Using magnetic resonance (MR) images of 30 patients referred for normal pressure hydrocephalus (NPH), EI, frontal-occipital horn ratio (FOR), third ventricular width and height, frontal horn width (FHW), and callosal angle (CA) at the foramen of Monro and the posterior commissure (PC) were independently measured by residents in neurosurgery and radiology, a neurosurgeon and radiologist, and a medical student. Intraclass correlation coefficients (ICC) were calculated to establish inter-rater agreement among the reviewers. Pearson's correlation coefficients were done to assess the relationship of the linear measurements with total ventricular volume. Kappa analyses were performed to assess the degree of agreement between cutpoints determined by the ROC analysis for the linear measurements and reviewers’ gestalt impression about ventricular size with volumetric abnormality.Results:The overall inter-rater agreement among reviewers was almost perfect for EI (ICC = 0.913), FOR (ICC = 0.830), third ventricular width, FHW (ICC = 0.88), and CA at PC (ICC = 0.865), substantial for temporal horn width (ICC = 0.729) and CA at foramen of Monro (ICC = 0.779), and moderate for third ventricular height (ICC = 0.496). EI, FOR, third ventricular width, temporal horn width, and CA at PC measures correlated with total ventricular volume. There was fair-to-almost-perfect agreement of the individual reviewer's gestalt responses of abnormatility with volumetric abnormality. Gestalt responses were better for more senior raters.Conclusion:Linear measurements are reliable and reproducible methods for determining ventricular enlargement.

Computerized tomographic study of normal Evans index in adult Nigerians.

Background:The evaluation of degree of ventricular enlargement should be based on established indices rather than on personal experience as this is highly subjective. Our aim was to establish normal values for Evans index in a Nigerian adult population as none has been found in the Nigerian medical literature.Materials and Methods:Axial computerized tomographic brain scans of 488 normal subjects were reviewed retrospectively. Of them, 319 (65.36%) of the patients were males and 169 (34.63%) were females; their ages ranged from 18 to 84 years with a mean age of 37.26 years. The images were acquired using a multi-slice GE Sigma excite scanner. Evans index was measured as the linear ratio of the total width of the frontal horns of the cerebral lateral ventricles to the maximum intracranial diameter.Results:The mean value for Evans index for the studied population was 0.252 ± 0.04. The EI increased with age and it was slightly higher among males. The difference in Evans value in males and females was not statistically significant. Individuals above 60 years old had the highest Evans values in both sexes.Conclusion:This study has established ranges of normal value for Evans index in a Nigerian population. It agrees with the diagnostic cut-off value of > 0.3 for hydrocephalus and it compares well with that of the Caucasians.

Sonography for diagnosis of Parkinson disease-from theory to practice: a study on 300 participants.

Hyperechogenicity of the substantia nigra on transcranial sonography is used for diagnosing Parkinson disease (PD). Cutoff values for the substantia nigra echogenic area, defining substantia nigra hyperechogenicity, vary among ultrasound systems from different manufacturers. In this study we wanted to determine the cutoff criterion for a Toshiba (Tokyo, Japan) system and to assess its diagnostic value. Three hundred participants (controls, n = 138; patients with PD, n = 105; and patients with essential tremor, n = 57) underwent transcranial sonography following a standardized protocol. The substantia nigra was assessable in 92.7% of all participants. The substantia nigra echogenic area (larger of bilateral measurements) was larger in patients with PD (mean ± SD, 0.24 ± 0.05 cm(2)) than controls (0.14 ± 0.05 cm(2); P < .001) and patients with essential tremor (0.14 ± 0.04 cm(2); P < .001). Substantia nigra echogenicity was larger in male participants (0.20 ± 0.07 cm(2)) than female participants (0.15 ± 0.06 cm(2); P< .001). Age did not correlate with substantia nigra echogenicity in any group. Frontal horn width was larger and lenticular nucleus hyperechogenicity and a discontinuous raphe were more frequent in the PD group than the other groups. On multivariate analysis, only substantia nigra hyperechogenicity was associated with the diagnosis of PD. The 90th-percentile substantia nigra echogenic area in the control group, which defined marked substantia nigra hyperechogenicity, also represented the optimum cutoff value for discrimination of PD from non-PD participants on receiver operating characteristic curve analysis (area under the curve, 0.913; Youden index, 0.73). This cutoff value (≥0.21 cm(2), larger of bilateral measurements) yielded sensitivity of 83% and specificity of 90% for the diagnosis of PD. Transcranial sonography shows good diagnostic validity for diagnosis of PD when implemented according to a strictly standardized protocol.

Biometria podal de equídeos (Equus sp Linnaeus, 1758) de tração

Os equídeos têm sido largamente utilizados como meio de tração desde épocas remotas, sem que se atente às intempéries às quais as cápsulas ungueais são submetidas, principalmente pelo atrito, pelo impacto e pelas forças atuantes no momento da tração. Para a mensuração das cápsulas ungueais foi utilizado paquímetro de aproximação milimetral e, para determinar a angulação da face parietal com o solo, transferidor de 180º. Os parâmetros das cápsulas ungueais mensurados foram: o comprimento, a largura, a altura da superfície dorsal da face parietal, a largura dos tórus córneos, a altura dos tórus córneos mediais e laterais, o comprimento e a largura da cunha córnea. Para confecção do presente trabalho foram utilizados 181 animais empregados em atividade de tração no Município de Petrolina (PE), sendo 56 equinos, 97 asininos e 28 muares, dentre machos e fêmeas, com diferentes massas corporais e diferentes idades. Os resultados foram tabulados e poderão servir de subsídio para determinação do padrão anatômico destes animais na referida região. Foi possível verificar as práticas às quais os animais são submetidos, como casqueamento, ferrageamento e excesso de carga, o que pode acarretar má distribuição da carga nos membros e na própria cápsula ungueal, gerando patologias do aparelho locomotor. Frequentemente, observava-se o desequilíbrio médio-lateral das úngulas, uma vez que o tórus córneo medial era maior que o lateral, desencadeando alterações no aprumo e prejudicando as posições ortostática e ortodinâmica, as quais poderiam ser resolvidos com práticas de casqueamento e ferrageamento, reduzindo as afecções do aparelho locomotor.

Morphometrics of the Entire Human Spinal Cord and Spinal Canal Measured From In Vivo High-Resolution Anatomical Magnetic Resonance Imaging

Measurements of cervical and thoracolumbar human spinal cord (SC) geometry based on in vivo magnetic resonance imaging and investigation of morphological "invariants." The current work aims at providing morphological features of the complete in vivo human normal SC and at investigating possible "invariant" parameters that may serve as normative data for individualized study of SC injuries. Few in vivo magnetic resonance image-based studies have described human SC morphology at the cervical level, and similar description of the entire SC only relies on postmortem studies, which may be prone to atrophy biases. Moreover, large interindividual variations currently limit the use of morphological metrics as reference for clinical applications or as modeling inputs. Absolute metrics of SC (transverse and anteroposterior diameters, width of anterior and posterior horns, cross-sectional SC area, and white matter percentage) were measured using semiautomatic segmentation of high resolution in vivo T2*-weighted transverse images acquired at 3 T, at each SC level, on healthy young (N = 15) and older (N = 8) volunteers. Robustness of measurements, effects of subject, age, or sex, as well as comparison with previously published postmortem data were investigated using statistical analyses (separate analysis of variance, Tukey-HSD, Bland-Altman). Normalized-to-C3 parameters were evaluated as invariants using a leave-one-out analysis. Spinal canal parameters were measured and occupation ratio border values were determined. Metrics of SC morphology showed large intra- and interindividual variations, up to 30% and 13%, respectively, on average. Sex had no influence except on posterior horn width (P < 0.01). Age-related differences were observed for anteroposterior diameter and white matter percentage (P < 0.05) and all postmortem metrics were significantly lower than in vivo values (P < 0.001). In vivo normalized SC area and diameters seemed to be invariants (R > 0.74, root-mean-square deviation < 10%). Finally, minimal and maximal occupation ratio were 0.2 and 0.6, respectively. This study presented morphological characteristics of the complete in vivo human SC. Significant differences linked to age and postmortem state have been identified. Morphological "invariants" that could be used to calculate the normally expected morphology accurately, were also identified. These observations should benefit to biomechanical and SC pathology studies. N/A.

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,...

Changes in third ventricular size in pediatric patients undergoing endoscopic third ventriculostomy

Optimal methods of evaluating radiographic data following endoscopic third ventriculostomy (ETV) are not yet known. This study analyzes imaging parameters, including third ventricular width and cross-sectional area (CSA), in pediatric ETV patients. Hydrocephalic pediatric patients treated by ETV at the senior authors' institution from 2004 to 2011 were stratified clinically (successful versus unsuccessful outcome) and retrospectively reviewed. Measured from pre- and post-operative imaging studies, third ventricular parameters included maximal width and mid-sagittal CSA, while lateral ventricular parameters included the ratio of greatest frontal horn width to co-linear skull internal diameter and the frontal-occipital horn ratio. Ten successful ETV patients (mean age 10.6years; range 11months to 19.8years) obtained imaging at least 2.75months following surgery, while four unsuccessful ETV patients (mean age 9.8years; range 4months to 17.3years) underwent imaging before repeat intervention. Third ventricular width showed an average decline of 0.32cm and 17.4% in the successful ETV cohort, but average increases of 0.35cm and 21.0% in the ETV failure group. Successful ETV patients exhibited mean decreases of 1.85cm(2) and 19.7% in third ventricular mid-sagittal CSA, while unsuccessful ETV patients showed mean increases of 1.17cm(2) and 17.3% per patient. These differences were statistically significant. Measures of lateral ventricular size showed similar trends, but with lower magnitude. Third ventricular imaging parameters (width and mid-sagittal CSA) exhibited more pronounced responses to ETV than lateral ventricular measurements in pediatric hydrocephalic patients.

1065 Reference Values of Ultrasound Brain Measurements in Preterm Newborn Infants

Background and AimsUltrasonography is noninvasive and commonly used for neuroimaging in premature newborns. Studies on brain measurement techniques and reference values of brain diameters are lacking. This paper aimed atdetermining...

Allometry of secondary, primary, and nonsexual traits in the beautiful demoiselle (Calopteryx virgo meridionalis)

The static allometry between the size of a trait and the body size results from the net selection forces acting on the evolution of both the trait and the body size. An increased knowledge of the functional significance of traits is necessary to understand observed allometric patterns. We studied several traits of males of the beautiful demoiselle ( Calopteryx virgo meridionalis Sélys, 1873), for which there is a good functional knowledge of the genitalic traits and ornaments. We found positive allometry for the wing spot size (considered a secondary sexual trait) and for the distal width (but not length) of the anal appendages, which are used for grasping the female prior to copulation. Regarding the male secondary genitalia, the length but not the width of the big horns of the aedeagus showed an isometric pattern. The aedeagus shaft length showed a negative allometric pattern, while its distal width did not show a significant regression. The slopes of the regressions were higher when using wing length than when using body length as estimators of body size, with the exception of wing spot length. Results are discussed based on the functional significance of the study traits, as well as the pre- and post-copulatory selective pressures acting on them.

Vascular Endothelial (VEGF) and Epithelial Growth Factor (EGF) as Well as Platelet‐Activating Factor (PAF) and Receptors are Expressed in the Early Pregnant Canine Uterus

The aim of this study was to investigate the course of expression of platelet-activating factor (PAF), PAF-receptor (PAF-R), epidermal growth factor (EGF), EGF-R, vascular endothelial growth factor (VEGF), VEGF-R1 and VEGF-R2 in uterine tissue during canine pregnancy. For this purpose, 20 bitches were ovariohysterectomized at days 10-12 (n = 10), 18-25 (n = 5) and 28-45 (n = 5) days after mating, respectively. The pre-implantation group was proven pregnant by embryo flushing of the uterus after the operation, the others by sonography. Five embryo negative, that is, non-pregnant, bitches in diestrus (day 10-12) served as controls. Tissue samples from the uterus (placentation sites and horn width, respectively) were excised and snap-frozen in liquid nitrogen after embedding in Tissue Tec(®). Extraction of mRNA for RT-PCR was performed with Tri-Reagent. In the embryos, mRNA from all factors except VEGF was detected. In the course of pregnancy, significantly higher expression of PAF and PAFR as well as VEGF and VEGFR2 during the pre-implantation stage than in all other stages and a strong upregulation of EGF during implantation were characteristic. The course of EGF was in diametrical opposition to the course of the receptor. These results point towards an increased demand for VEGF, EGF and PAF during the earliest stages of canine pregnancy.

Morphometric MRI evaluation of corpus callosum and ventricles in normal adults

Objectives: The aim of this study was to determine the normal values of subregions of corpus callosum and ventricles in healthy adult people in our population using magnetic resonance imaging (MRI) and to establish gender differences.Methods: The MRI of 52 healthy individuals (29 females and 23 males) aged 20-50 years was obtained. The measurements were performed from MRI on a workstation. The midsagittal images were used for measurements of the subregions of corpus callosum and axial images were for lateral and third ventricles.Results: The mean values of the widths of genu, body, splenium, and height of the corpus callosum were 13·28±2·10, 7·64±1·07, 12·52±1·35, and 25·47±2·20 mm, respectively in females; whereas, the same measurements were 13·23±2·41, 6·89±2·12, 11·90±1·94, and 25·03±3·38 mm, respectively in males. Moreover, the mean value for the longitudinal dimension of the brain was 150·12±5·04 mm, while that for the corpus callosum was 71·27±3·70 mm in females. Additionally, the mean frontal horn width of the lateral ventricle and the transverse inner diameter of the skull were 34·06±3·05 and 130·76±6·71 mm in females and 34·03±2·78 and 129·96±10·61 mm in males, respectively. Due to these measurements, the values of Evans index which is reflecting the lateral ventricle enlargement were estimated to be 0·25±1·90 and 0·25±1·14 in females and males, respectively. According to our last measurement result, the mean values for the third ventricle width were 3·79±0·85 and 4·12±0·94 mm in females and males, respectively. These findings show that there are differences between the averages of some indices of corpus callosum of our population and the other populations.

New Reference Values for the Neonatal Cerebral Ventricles

To establish new cross-sectional reference values for the size of the lateral ventricles in a large cohort of neonates between 24 and 42 weeks' gestational age (GA) as well as longitudinal reference values for the follow-up of very preterm infants born at less than 30 weeks' gestation. Institutional review board approval and parental written informed consent were obtained for this prospective cohort study of 625 neonates (58% male patients) with a median GA of 33.4 weeks (range, 24.7-42.6 weeks). All infants underwent cranial ultrasonography (US) within 4 days after birth to evaluate the size of the lateral ventricles. Scanning was repeated in 301 preterm and term neonates within the 1st week of life to assess the presence of ventricular reopening. Seventy-nine very preterm infants (GA, <30 weeks) were prospectively included for cranial US at term-equivalent age (TEA). US measurements were performed of the ventricular index (VI), anterior horn width (AHW), and thalamo-occipital distance (TOD). Statistical analysis was conducted by using a paired t test, multilevel analysis, and analysis of covariance. Cross-sectional reference values for the VI and TOD increased with maturity, whereas the AHW remained constant. Vaginal birth was independently associated with a slightly smaller AHW following birth and with an increase in AHW within the 1st week of life (P < .05). Preterm-born infants showed a larger ventricular size at TEA compared with term infants (P < .001). New cross-sectional and longitudinal reference curves were established for the size of the neonatal lateral ventricles, which may allow for early identification and quantification of ventriculomegaly due to either posthemorrhagic ventricular dilation or periventricular white matter loss.

Prognostic Value of Intraventricular Bleeding in Spontaneous Intraparenchymal Cerebral Hemorrhage of Small Volume

The literature is controversial on whether intraventricular bleeding has a negative impact on the prognosis of spontaneous intracerebral hemorrhage. Nevertheless, an association between intraventricular bleeding and spontaneous intracerebral hemorrhage volumes has been consistently reported. To evaluate the prognostic value of intraventricular bleeding in deep intraparenchymal hypertensive spontaneous hemorrhage with a bleeding volume <30 cm(3). Of the 320 patients initially evaluated, 33 met the inclusion criteria and were enrolled in this prospective study. The volume of intraparenchymal hemorrhage was calculated by brain computed tomography (CT) image analysis, and the volume of intraventricular bleeding was calculated by the LeRoux scale. Clinical data, including neurological complications, were collected daily during hospitalization. Neurological outcome was evaluated 30 days after the event by using the Glasgow outcome scale. Patients were assigned to 1 of 3 groups according to intraventricular bleeding: Control, no intraventricular bleeding; LR 1, intraventricular bleeding with LeRoux scale scores of 1 to 8; or LR 2, intraventricular bleeding with LeRoux scale scores >8. There were no significant differences among groups concerning age, mean blood pressure, and time from onset to brain CT scan. Patients with greater intraventricular bleeding presented lower initial Glasgow coma scale scores, increased ventricular index and width of temporal horns, increased number of clinical and neurological complications, and longer hospitalization. Furthermore, their relative risk for unfavorable clinical outcome was 1.9 (95% confidence interval 1.25-2.49). Intraventricular bleeding with a LeRoux scale score >8 appears to have a negative effect on deep spontaneous intraparenchymal cerebral hemorrhage of small volume.

Notes on Biology and Behavior of Rhinoceros Beetle Enema pan (Coleoptera: Scarabaeidae: Dynastinae)

Abstract Dynastinae beetles (Coleoptera: Scarabaeidae) are important due to their role in recycling plant material and promoting nutrient turnover. However, some species are phytophagous and can attack crop plants, thus becoming pests. Here, we provide information on the biology and behavior of the rhinoceros beetle Enema pan (F.) (Oryctini), an abundant species in the area of Cerrado-Pantanal ecotone, Aquidauana, Mato Grosso do Sul, Brazil. Adults were collected with a light trap deployed daily from January 2006 to December 2007 in the experimental farm of the Universidade Estadual de Mato Grosso do Sul (Aquidauana campus). Adults were maintained in plastic containers and observations were made daily. Temporal distribution of adults of E. pan occurred in September and October (2006) and from October to December (2007). Flight started at 1930 hours and ended at 2330 hours. Twenty-four eggs (3.28 mm in length by 2.32 mm in width) with a whitish color were ovipositioned directly in to the soil. Adult longevity averaged 22.0 d in the laboratory conditions. Cephalic horn length, body length, and width of E. pan males are greater than those of females. The weight of adults of both sexes was similar. Cephalic horn length of the males of E. pan was positively correlated with his body size. Mating occurred between 0800 and 1030 hours and lasted on average 18.1 min in the laboratory. Several fights among males and other behaviors involving males and females were observed and are reported.