Temporal Horn Enlargements Predict Secondary Hydrocephalus Diagnosis Earlier than Evans’ Index

Missori, Paolo; Paolini, Sergio; Peschillo, Simone; Mancarella, Cristina; Scafa, Anthony Kevin; Rastelli, Emanuela; Martini, Stefano De; Fattapposta, Francesco; Currà, Antonio

doi:10.3390/tomography8030115

Cited by 5 publications

(4 citation statements)

References 13 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To prevent damage to the periventricular temporal brain, it is particularly important to determine ventricular enlargements as early as possible, well before EI becomes positive. Unlike primary hydrocephalus, a very sensitive sign of secondary ventricular enlargement is the dilatation of the temporal horns and posterior horns [ 26 ]. Moreover, the width of the third ventricle increases so that it is no longer slit-shaped but rather ballooned or laterally bowed.…”

Section: Discussionmentioning

confidence: 99%

Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes

Dong

Bao

et al. 2023

Neurol Ther

View full text Add to dashboard Cite

Introduction As a disorder of the brain in adults and children, traumatic brain injury (TBI) is considered the major cause of mortality and morbidity. As a serious complication of TBI, post-traumatic hydrocephalus (PTH) is commonly identified and significantly associated with neurocognitive impairment, motor dysfunction, and growth impairment. The long-term functional outcomes after shunt dependence are totally not clear. Methods This study included 6279 patients between 2012 and 2022. To identify the unfavorable functional outcomes and the PTH-related factors, we carried out univariable logistic regression analyses. To identify the occurrence time of PTH, we conducted the log-rank test and Kaplan–Meier analysis. Results Mean patient age was 51.03 ± 22.09 years. Of the 6279 patients with TBI, 327 developed PTH (5.2%). Several PTH development-associated factors, such as intracerebral hematoma, diabetes, longer initial hospital stay, craniotomy, low GCS (Glasgow Coma Scale), EVD (external ventricular drain), and DC (decompressive craniectomy) ( p < 0.01), were identified. We also analyzed the factors of unfavorable outcomes after TBI including > 80 years, repeated operations, hypertension, EVD, tracheotomy, and epilepsy ( p < 0.01). Ventriculoperitoneal shunt (VPS) itself is not an independent factor of the unfavorable outcome but shunt complication is a strong independent factor of unfavorable outcome ( p < 0.05). Conclusion We should emphasize the practices that can minimize the risks of shunt complications. Additionally, the rigorous radiographic and clinical surveillance will benefit those patients at high risk of developing PTH. Trial registration ClinicalTrials.gov identifier, ChiCTR2300070016. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-023-00511-7.

show abstract

Section: Discussionmentioning

confidence: 99%

Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes

Dong

Bao

et al. 2023

Neurol Ther

View full text Add to dashboard Cite

show abstract

“…A diagnosis of hydrocephalus is established when an Evans’ index value exceeds 0.30 ( 20 ). The distance between frontal horns is determined by measuring a continuous plane, while the maximum internal diameter in that same plane determines its former ( 21 ). Temporal horn widths are measured strictly at the ventricular prominence level, where their cavities should rarely exceed 1 mm in width; diameters greater than 2 mm in adults are considered pathological ( 12 ).…”

Section: Methodsmentioning

confidence: 99%

A predictive model in patients with chronic hydrocephalus following aneurysmal subarachnoid hemorrhage: a retrospective cohort study

Rao,

Yang,

Enxi

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveOur aim was to develop a nomogram that integrates clinical and radiological data obtained from computed tomography (CT) scans, enabling the prediction of chronic hydrocephalus in patients with aneurysmal subarachnoid hemorrhage (aSAH).MethodA total of 318 patients diagnosed with subarachnoid hemorrhage (SAH) and admitted to the Department of Neurosurgery at the Affiliated People’s Hospital of Jiangsu University between January 2020 and December 2022 were enrolled in our study. We collected clinical characteristics from the hospital’s medical record system. To identify risk factors associated with chronic hydrocephalus, we conducted both univariate and LASSO regression models on these clinical characteristics and radiological features, accompanied with penalty parameter adjustments conducted through tenfold cross-validation. All features were then incorporated into multivariate logistic regression analyses. Based on these findings, we developed a clinical-radiological nomogram. To evaluate its discrimination performance, we conducted Receiver Operating Characteristic (ROC) curve analysis and calculated the Area Under the Curve (AUC). Additionally, we employed calibration curves, and utilized Brier scores as an indicator of concordance. Additionally, Decision Curve Analysis (DCA) was performed to determine the clinical utility of our models by estimating net benefits at various threshold probabilities for both training and testing groups.ResultsThe study included 181 patients, with a determined chronic hydrocephalus prevalence of 17.7%. Univariate logistic regression analysis identified 11 potential risk factors, while LASSO regression identified 7 significant risk factors associated with chronic hydrocephalus. Multivariate logistic regression analysis revealed three independent predictors for chronic hydrocephalus following aSAH: Periventricular white matter changes, External lumbar drainage, and Modified Fisher Grade. A nomogram incorporating these factors accurately predicted the risk of chronic hydrocephalus in both the training and testing cohorts. The AUC values were calculated as 0.810 and 0.811 for each cohort respectively, indicating good discriminative ability of the nomogram model. Calibration curves along with Hosmer-Lemeshow tests demonstrated excellent agreement between predicted probabilities and observed outcomes in both cohorts. Furthermore, Brier scores (0.127 for the training and 0.09 for testing groups) further validated the predictive performance of our nomogram model. The DCA confirmed that this nomogram provides superior net benefit across various risk thresholds when predicting chronic hydrocephalus. The decision curve demonstrated that when an individual’s threshold probability ranged from 5 to 62%, this model is more effective in predicting the occurrence of chronic hydrocephalus after aSAH.ConclusionA clinical-radiological nomogram was developed to combine clinical characteristics and radiological features from CT scans, aiming to enhance the accuracy of predicting chronic hydrocephalus in patients with aSAH. This innovative nomogram shows promising potential in assisting clinicians to create personalized and optimal treatment plans by providing precise predictions of chronic hydrocephalus among aSAH patients.

show abstract

“…Inclusion criteria: x History of DC; y hydrocephalus diagnosed by CT or MRI (15)(16)(17); (Evan's index >0.3, or associated with periventricular interstitial edema; Other causes of ventricular enlargement were excluded. z The presence of hydrocephalusrelated symptoms, such as headache, neurological dysfunction, etc., normal pressure hydrocephalus contains at least one of the following symptoms: gait disorders, cognitive disorders, urinary incontinence (18)(19)(20).…”

Section: Methods Patients Selectionmentioning

confidence: 99%

The compensatory mechanism and clinical significance of hydrocephalus after cranioplasty

Qiu

Wang²,

Chen³

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveCranioplasty (CP) and ventriculoperitoneal shunt (VPS) are procedures required after decompression of the flap (DC) to protect the cranial frame and prevent hydrocephalus. This study evaluated the safety and efficacy of different surgical sequences of CP and VPS after DC and identified risk factors for necessary permanent VPS.MethodsFrom January 2017 to December 2021, valid follow-up data were collected in 192 cases. The observation group preferred CP, and then evaluated whether to receive VPS according to the progress of hydrocephalus. the control group was prioritized for VPS and continued with CP after 1 week. The improvement of hydrocephalus symptoms, follow-up outcomes, and post-operative complications before and after surgery were compared between the two groups, and univariate analysis was used to determine the risk factors for necessary permanent risk factors for VPS.ResultsThere were 86 cases (44.8%) in the observation group, who received CP first, while 106 cases (55.2%) in the control group received VPS and CP, respectively. There was no significant difference between the two groups according to Barthel index, FMAS, Mrs, GCS, and Evans index, and there was no statistical difference in complications between the two groups. However, in the observation group, hydrocephalus disappeared after CP operation in 29 cases (33.7%), and finally avoided VPS. Univariate analysis showed that the main etiology was related to the size of the skull defect, the distance of the talus margin relative to the flap to the midline, and lumbar puncture pressure was a predictor of the need for permanent VPS.ConclusionThis study provides detailed information on the efficacy and complications of different sequences of preferential CP or VPS after DC surgery. We found that priority CP reduced the incidence of VPS surgery without affecting surgical outcomes and complications.

show abstract

Temporal Horn Enlargements Predict Secondary Hydrocephalus Diagnosis Earlier than Evans’ Index

Cited by 5 publications

References 13 publications

Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes

Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes

A predictive model in patients with chronic hydrocephalus following aneurysmal subarachnoid hemorrhage: a retrospective cohort study

The compensatory mechanism and clinical significance of hydrocephalus after cranioplasty

Contact Info

Product

Resources

About