The importance of measuring mamillopontine distance as a diagnostic criterion of hydrocephalus degrees

Abstract

Objectives:The occurrence of obstructive hydrocephalus (ObH) as sequelae of deep midline brain tumors (third and lateral ventricles, thalamic, pineal region, brainstem, and fourth ventricle) can be estimated up to 90% of cases. We believe that the mamillopontine distance (MPD) – the distance between the lower surface of the mammillary body and the upper surface of the pons in the sagittal images – can be a sufficiently reliable alternative to the Evans’ index (EI) for the diagnosis of ObH.Patients and Methods:The results of mamillopontine distance (MPD), Evans’ index (EI), and angle of corpus callosum (ACC) measurement of 43 patients with non-communicative hydrocephalus were analyzed compared with results of 30 people without brain pathology.Results:Findings revealed that MPD is a strong and reliable alternative to the EI. MPD showed high specificity and sensitivity in the diagnosis of occlusive hydrocephalus. Moreover, from those findings, we have proposed classification of the degree of hydrocephalus severity, depending on the MPD.Conclusion:MPD one of the more accurate and powerful method for defining presence of hydrocephalus in-patient even in early stage of occlusion. It has high specificity and sensitivity and capable classify hydrocephalus into grades according to severity.

Spontaneous Intracranial Hypotension: Case Report and Update on Diagnosis and Treatment

“…The mammilopontine distance is the shortest distance between the inferior margin of the mammillary bodies and the superior surface of the pons, measured in mid-sagittal T1-weighted images. It is normally around 7 mm [9] or even 9 mm [10], whereas in our patient it was 6.7 mm. In addition, the pituitary gland was enlarged and hyperemic.…”

“…The mammilopontine distance is the shortest distance between the inf margin of the mammillary bodies and the superior surface of the pons, measured in sagittal T1-weighted images. It is normally around 7 mm [9] or even 9 mm [10], whe in our patient it was 6.7 mm. In addition, the pituitary gland was enlarged and hypere In our view, the main diagnostic possibilities at this stage were idiopathic pachym ingitis or secondary pachymeningitis (either in Wegener granulomatosis-considerin persisting nasal discharge or an IgG4-related one).…”

Investigation of Morphometric Characteristics of the Mesencephalon in a Healthy Turkish Population: An MRI-Based Morphometric Study

“…Kariev et al (2019) reported that MPD is an alternative measurement with high specificity in the diagnosis of obstructive hydrocephalus [ 10 ]. In another study with 43 patients and 30 control groups, the mean MPD value of the patient group was found to be 3.4 mm and 9.8 mm in the control group [ 5 ].…”

“…Pontomesencephalic angle (PMA) and mamillopontine distance (MPD) have been found useful in the diagnosis of intracranial hypotension. It has also been reported that MPD is a useful aid in the diagnosis of hydrocephalus [8][9][10][11][12].…”