Introduction
The loss of parenchymal brain volume per normative age comparison is a distinctive feature of brain atrophy. While the condition is the most prevalent to elderly, it has also been observed in pediatric ages. Various causes such as trauma, infection, and malnutrition have been reported to trigger the loss of brain tissues volume. Despite this literature based knowledge of risk factors, the magnitude of brain atrophy in pediatric age group is scantly addressed in most developing countries including Tanzania. The current study aims to understand the magnitude of brain atrophy in children residing in Northern Zone, Tanzania.
Methods
A cross-sectional hospital survey was performed in which 455 children who were presented with various brain pathologies from the year 2013 to 2019 and whose brains examined by Computerized tomography (CT)-Scanners were recruited in the study. The brain statuses were examined using three linear radiological methods including the measure of sulcal-width, Evans index, and lateral ventricular body width.
Results
Results showed a significant number of atrophied brains among children in Northern Tanzania and that the condition was observed to have a 1:1 male to female ratio. The prevalence of pediatric brain atrophy was found to be 16.04%.
Conclusion
The cortical subtype of brain atrophy presented as the most prevalent type of brain volume loss. The findings of this study suggest existence of considerable trends of brain atrophy in children which need special attention and mitigation plans.
Background
The brain is a dynamic organ that develops and involutes in volume. The process of volume loss known as brain atrophy commonly occurs in elderly. However, some conditions have been implicated to provoke this paradoxical process in childhood and making it important to have methods and techniques of quantifying brain volume. Automated quantitative methods are very important in brain atrophy assessment but these tools have limited availability in developing countries. The simplified linear radiological methods are poorly reproducible and hence there is a need to develop an alternative formula that is reproducible and applicable at all healthcare levels.
Methods
The multi-linear diagonal brain fraction formula (DBF) was designed from dimensions of brain relative to skull. To test a developed formula, a total of 347 subjects aged between 0 and 18 years who had brain CT scans performed at the health facilities in Northern Tanzania were recruited and subjected to a systematic measurement of their brains in a diagonal brain fashion.
Results
Out of 347 patients evaluated, 62 subjects (17.8%) were found to be cases of brain atrophy. The three radiological measurements which included sulcal width (SW), ventricular width (VW) and Evans Index (EI) were concurrently performed. SW and VW showed good age correlation while EI showed no significant correlation with age. Similar tests were extended to diagonal brain fraction (DBF) and skull vertical horizontal ratio (VHR) in which DBF showed significant correlation.
Conclusions
The DBF formula shows significant ability of differentiating changes of brain volume suggesting that it can be utilized as an alternative brain fraction quantification method bearing technical simplicity in assessing gross brain volume with the ability to classify degrees of brain atrophy into mild, moderate, severe and very severe stages.
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