Intracranial volume change in craniosynostosis

1999 ◽  
Vol 91 (4) ◽  
pp. 617-625 ◽  
Author(s):  
Spiros Sgouros ◽  
Anthony D. Hockley ◽  
J. Henry Goldin ◽  
Michael J. C. Wake ◽  
Kalyan Natarajan
Keyword(s):  
Volume Growth ◽  
Underlying Mechanism ◽  
Intracranial Volume ◽  
Healthy Children ◽  
Optimum Time ◽  
Content Type ◽  
Head Growth ◽  
The Difference ◽  
Cranial Expansion ◽  
Fine Print

Object. There is still controversy regarding the optimum time to perform surgery for craniosynostosis. Some recommend surgery soon after birth and others delay until the age of 12 months. Intracranial pressure has been measured in an attempt to provide a scientific rationale, but many questions remain unanswered. To date, little attention has been given to intracranial volume and its changes during the first few years of life in children with craniosynostosis. The authors' goal was to focus on intracranial volume during this period and to compare measurements obtained in patients with craniosynostosis with measurements obtained in healthy individuals.Methods. Using the technique of segmentation, the intracranial volume of 84 children with various forms of craniosynostosis was measured on preoperative computerized tomography scans. The change in average volume that occurs with increasing age was calculated and compared with a model of normal intracranial volume growth. The age at presentation for children with craniosynostosis was 1 to 39 months; 76% of the patients were younger than 12 months. In eight patients in whom only one cranial expansion procedure was performed, postoperative intracranial volumes were measured as well. Several interesting observations emerged. 1) There was little difference in head growth between boys and girls with craniosynostosis during the first few months of life. After the age of 12 months, however, the difference in intracranial volume normally seen between the two genders was observed in the craniosynostosis group as well. 2) Excluding children with complex pansynostosis, who have smaller heads, children with all other types of craniosynostosis have similar head growth after the 1st year of life, with no difference between the number of and type of suture affected. Children with Apert's syndrome develop greater than normal intracranial volumes after the 1st year of life. 3) Although children with craniosynostosis are born with a smaller intracranial volume, by the age of 6 months volume has reached normal levels, and from that point on volume follows the pattern of normal head growth. 4) Children who presented after the age of 6 months and later developed recurrent craniosynostosis after initial successful treatment had a small intracranial volume at their initial presentation. 5) Of the patients whose postoperative intracranial volumes were measured, all but one had preoperative volumes at or above normal values, and their postoperative volumes were considerably higher than normal for their age. These children all followed a growth curve parallel to that of healthy children but at higher volume value. One patient with a smaller-than-normal initial intracranial volume was surgically treated at a very young age and, despite cranial expansion surgery, postoperative volume did not reach normal levels. It is postulated that this was due to the fact that the operation was performed at a time when craniosynostosis was still active.Conclusions. The results of this study indicate that the underlying mechanism leading to craniosynostosis and constriction of head volume “exhausts” its effect during the first few months of life. Measurement of intracranial volume in clinical practice could be used to “fine tune” the optimum time for surgery. In late-presenting children, this may be useful in predicting possible recurrence.

Normal changes in orbital volume during childhood

2002 ◽  
Vol 96 (4) ◽  
pp. 742-746 ◽  
Author(s):  
Robert P. Bentley ◽  
Spyros Sgouros ◽  
Kalyan Natarajan ◽  
M. Stephen Dover ◽  
Anthony D. Hockley
Keyword(s):  
Statistical Significance ◽  
Significant Proportion ◽  
Magnetic Resonance Images ◽  
Healthy Children ◽  
Content Type ◽  
Linear Pattern ◽  
Orbital Volume ◽  
Disease States ◽  
The Difference ◽  
Fine Print

Object. The aim of this study was to construct a model of changes in orbital volume that occur throughout childhood from the age of 1 month to 15 years, which could be used for comparative studies of disease states affecting orbital growth. Methods. Using the procedure of segmentation on magnetic resonance images obtained in 67 healthy children, orbital volume was measured and plotted against age. During the first few months of life left orbital volume is on average 15 cm3 in male and 13 cm3 in female infants; these volumes increase to 26 cm3 and 24 cm3, respectively, by the time the child reaches 15 years of age. During the first few months of life right orbital volume is on average 16 cm3 in male and 13 cm3 in female infants; these volumes increase to 27 cm3 and 25 cm3, respectively, by the time the child is 15 years old. This represents an overall increase in orbital volume by a factor of 1.7 in boys and 1.8 in girls. By the time the child has reached 5 years of age, the orbital volume for both right and left sides has reached on average 77% of the volume seen at 15 years in both sexes. The differences between the two sides are not statistically significant for either sex. The change in orbital volume that is associated with age in general displays a linear pattern. Throughout childhood, orbital volumes are larger in boys than in girls, but share a similar growth pattern. The difference between the two sexes tends toward statistical significance during the first 5 years of life (left orbit p = 0.1, right orbit p = 0.04). Conclusions. During early childhood, orbital volume increases in a linear fashion, achieving a significant proportion of its final growth by the time the child is 5 years old.

Age-related changes in intracranial compartment volumes in normal adults assessed by magnetic resonance imaging

1996 ◽  
Vol 84 (6) ◽  
pp. 982-991 ◽  
Author(s):  
Mitsunori Matsumae ◽  
Ron Kikinis ◽  
István A. Mórocz ◽  
Antonio V. Lorenzo ◽  
Tamás Sándor ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Brain Volume ◽  
Intracranial Volume ◽  
Mr Image ◽  
Content Type ◽  
Age Related ◽  
The Difference ◽  
Normal Adults ◽  
Fine Print ◽  
Age Related Changes

✓ Magnetic resonance (MR) image—based computerized segmentation was used to measure various intracranial compartments in 49 normal volunteers ranging in age from 24 to 80 years to determine age-related changes in brain, ventricular, and extraventricular cerebrospinal fluid (CSF) volumes. The total intracranial volume (sum of brain, ventricular, and extraventricular CSF) averaged 1469 ± 102 cm3 in men and 1289 ± 111 cm3 in women. The difference was attributable primarily to brain volume, which accounted for 88.6% of the respective intracranial volumes in both sexes, but was significantly larger in men (1302 ± 112 cm3) than in women (1143 ± 105 cm3). In both, the cranial CSF volume averaged 11.4%. Total intracranial volume did not change with age, although the normalized brain volume of both men and women began to decrease after the age of 40 years. This decrease was best reflected by expansion of the extraventricular CSF volume which, after the age of 50 years, was more marked in men than in women. The volume of the cranial CSF, as determined by MR image-based computerized segmentation, is considerably larger than traditionally accepted and resides mostly extraventricularly. Expansion of CSF volume with age provides a good index of brain shrinkage although evolving changes and growth of the head with age tend to confound the results.

Intracranial volume change in childhood

1999 ◽  
Vol 91 (4) ◽  
pp. 610-616 ◽  
Author(s):  
Spiros Sgouros ◽  
J. Henry Goldin ◽  
Anthony D. Hockley ◽  
Michael J. C. Wake ◽  
Kalyan Natarajan
Keyword(s):  
Magnetic Resonance ◽  
Volume Change ◽  
Growth Pattern ◽  
Magnetic Resonance Images ◽  
Intracranial Volume ◽  
Healthy Children ◽  
Content Type ◽  
Similar Growth ◽  
Fine Print

Object. The goal of this study was to construct a model of normal changes in intracranial volume occurring throughout childhood from age 7 days to 15 years.Methods. Using the technique of segmentation on magnetic resonance images obtained in healthy children, intracranial volume was measured and plotted against age.Conclusions. Intracranial volume in the first few months of life is on average 900 cm3 in males and 600 cm3 in females. By the age of 15 years, it increases up to 1500 cm3 in males and 1300 cm3 in females, increased by factors of 1.6 and 2.1, respectively. By the time the child reaches 2 years of age, intracranial volume has reached 77% (1150 cm3 in males and 1000 cm3 in females) and, by 5 years, 90% (1350 cm3 in males and 1200 cm3 in females) of the volume observed at age 15 years. The change in intracranial volume that occurs with age is not linear, but there seems to be a segmental pattern. Three main periods can be distinguished, each lasting approximately 5 years (0–5, 5–10, and 10–15 years), during which the growth of intracranial volume is linear. Throughout childhood, males have higher intracranial volumes than females, with a similar growth pattern.

Influence of shunt type on ventricular volume changes in children with hydrocephalus

2003 ◽  
Vol 98 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Chris Xenos ◽  
Spiros Sgouros ◽  
Kalyan Natarajan ◽  
A. Richard Walsh ◽  
Anthony Hockley
Keyword(s):  
Statistical Significance ◽  
Ventricular Volume ◽  
Magnetic Resonance Images ◽  
Healthy Children ◽  
Content Type ◽  
Shunt Placement ◽  
Age Related ◽  
The Mean ◽  
The Difference ◽  
Fine Print

Object. The goal of this study was twofold: to investigate the change in ventricular volume in children with hydrocephalus in response to shunt placement and to assess the effects of two different valve types (Medium Pressure [MP] cylindrical valve and Delta [model 1.5] valve). Methods. Ventricular volume was measured using segmentation techniques on computerized tomography scans and magnetic resonance images obtained in 40 children with hydrocephalus who ranged in age from 4 days to 16 years. Imaging was performed preoperatively and at 5 days and 3, 6, and 12 months postoperatively. The results were compared with measurements obtained in 71 healthy children ranging in age from 1 month to 15 years. Each ventricular volume that was measured was divided by the corresponding sex and age—related mean normal volume to calculate the “× normal” ventricular volume, indicating how many times larger than normal the ventricle was. The mean preoperative ventricular volume was 232 cm3 (range 50–992 cm3). The mean postoperative volumes were 147, 102, 68, and 61 cm3 at 5 days and at 3, 6, and 12 months posttreatment, respectively. The mean preoperative × normal ventricular volume was 14.5 (range 2.2–141.7), and the mean postoperative × normal volumes were 7.9, 5.6, 3.5, and 2.9 at 5 days and 3, 6, and 12 months postimplantation, respectively. The rate of volume reduction was consistently higher in patients who received the MP valve in comparison with those who received the Delta valve, both for new shunt insertions and for shunt revisions. The difference between the two valve groups did not reach statistical significance. Two patients in whom ventricular volumes increased during the study period experienced shunt obstruction at a later time. Conclusions. Preoperative ventricular volume in children with hydrocephalus can be up to 14 times greater than normal. In response to shunt placement, the ventricular volume continues to fall during the first 6 months after operation. The effect is more profound in children who receive the MP valve than in those who receive the Delta valve, although in this study the authors did not demonstrate statistical significance in the difference between the two valves. Nevertheless, this may indicate that the MP valve produces overdrainage in comparison with the Delta valve, even within the first few months after insertion. There is some indication that sequential ventricular volume measurement may be used to identify impending shunt failure.

Changes in orbital volume during childhood in cases of craniosynostosis

2002 ◽  
Vol 96 (4) ◽  
pp. 747-754 ◽  
Author(s):  
Robert P. Bentley ◽  
Spyros Sgouros ◽  
Kalyan Natarajan ◽  
M. Stephen Dover ◽  
Anthony D. Hockley
Keyword(s):  
Surgical Intervention ◽  
Volume Growth ◽  
Normal Growth ◽  
Underlying Mechanism ◽  
Growth Patterns ◽  
Content Type ◽  
Orbital Volume ◽  
Significant Difference ◽  
Normal Mean ◽  
Fine Print

Object. Controversy remains concerning the timing of frontoorbital advancement (FOA) surgery performed for craniosynostosis. Reduced orbital volume and degree of exorbitism are often cited as reasons for early surgical intervention. To date, however, little attention has been given to orbital volume and its changes during the first few years of life as an indicator of orbital growth in children with craniosynostosis. Knowledge of orbital volume and growth patterns in individuals with craniosynostosis and those with normal cranial structures will enable surgeons to refine both the type and timing of surgical intervention required, thus obtaining the optimum outcome for their patients. Methods. Using the procedure of segmentation, orbital volumes in 50 children with various forms of craniosynostosis were measured on preoperative computerized tomography scans. Changes in average volume that occur with increasing age were calculated and compared with a model of normal orbital volume growth. At presentation the children with craniosynostosis ranged in age from 1 to 29 months, with 82% of them within the 1st year of life. Several interesting observations emerged from this study. Excluding patients with unilateral coronal synostosis, there was no difference between orbital volumes measured on the right and left sides, allowing mean orbital volume measurements to be used for comparative purposes. Although children with craniosynostosis begin life with significantly smaller orbital volumes, overall normal mean volumes for both sexes are attained by 13 months of age, with volumes approaching normal by 6 months of age in male infants and by 8 months of age in female infants. Changes in orbital volume associated with age generally appear to be similar in most forms of craniosynostosis. There appears to be no significant difference in changes in orbital volume between children with syndromic or nonsyndromic forms of bicoronal synostosis. Orbital volume is significantly reduced on the ipsilateral affected side in cases of unicoronal synostosis in comparison with the contalateral side, but it is not significantly lower than that of normal. Finally, FOA surgery appears to restore normal growth of orbital volume. Conclusions. The results of this study indicate that the underlying mechanism leading to craniosynostosis and restriction of orbital volume “burns out” and begins to lose its major effects within the first few months of life. It would appear that FOA surgery should be delayed until the end of the second half of the 1st year of life, thus maximizing the effects of accelerated normal orbital growth and reducing the risks of relapse.

The mechanism and effect of chronic electrical stimulation of the globus pallidus for treatment of Parkinson disease

2004 ◽  
Vol 100 (6) ◽  
pp. 997-1001 ◽  
Author(s):  
Mitsuhiro Ogura ◽  
Naoyuki Nakao ◽  
Ekini Nakai ◽  
Yuji Uematsu ◽  
Toru Itakura
Keyword(s):  
Electrical Stimulation ◽  
Parkinson Disease ◽  
Globus Pallidus ◽  
Rating Scale ◽  
Underlying Mechanism ◽  
Clinical Effects ◽  
Content Type ◽  
Chronic Electrical Stimulation ◽  
Fine Print ◽  
Stimulation Of

Object. Although chronic electrical stimulation of the globus pallidus (GP) has been shown to ameliorate motor disabilities in Parkinson disease (PD), the underlying mechanism remains to be clarified. In this study the authors explored the mechanism for the effects of deep brain stimulation of the GP by investigating the changes in neurotransmitter levels in the cerebrospinal fluid (CSF) during the stimulation. Methods. Thirty patients received chronic electrical stimulation of the GP internus (GPi). Clinical effects were assessed using the Unified PD Rating Scale (UPDRS) and the Hoehn and Yahr Staging Scale at 1 week before surgery and at 6 and 12 months after surgery. One day after surgery, CSF samples were collected through a ventricular tube before and 1 hour after GPi stimulation. The concentration of neurotransmitters such as γ-aminobutyric acid (GABA), noradrenaline, dopamine, and homovanillic acid (HVA) in the CSF was measured using high-performance liquid chromatography. The treatment was effective for tremors, rigidity, and drug-induced dyskinesia. The concentration of GABA in the CSF increased significantly during stimulation, although there were no significant changes in the level of noradrenaline, dopamine, and HVA. A comparison between an increased rate of GABA concentration and a lower UPDRS score 6 months postimplantation revealed that the increase in the GABA level correlated with the stimulation-induced clinical effects. Conclusions. Stimulation of the GPi substantially benefits patients with PD. The underlying mechanism of the treatment may involve activation of GABAergic afferents in the GP.

Intracranial volume-pressure relationship in man

1982 ◽  
Vol 56 (4) ◽  
pp. 524-528 ◽  
Author(s):  
Joseph Th. J. Tans ◽  
Dick C. J. Poortvliet
Keyword(s):  
Best Approximation ◽  
Continuous Monitoring ◽  
Fluid Pressure ◽  
Constant Term ◽  
Volume Index ◽  
Intracranial Volume ◽  
Content Type ◽  
The Best Approximation ◽  
Ventricular Fluid Pressure ◽  
Fine Print

✓ The pressure-volume index (PVI) was determined in 40 patients who underwent continuous monitoring of ventricular fluid pressure. The PVI value was calculated using different mathematical models. From the differences between these values, it is concluded that a monoexponential relationship with a constant term provides the best approximation of the PVI.

Associated change in plantar temperature and sweating after transthoracic endoscopic T2–3 sympathectomy for palmar hyperhidrosis

2001 ◽  
Vol 95 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Han-Jung Chen ◽  
Cheng-Loong Liang ◽  
Kang Lu
Keyword(s):  
Skin Temperature ◽  
Temperature Change ◽  
The Body ◽  
Palmar Hyperhidrosis ◽  
Compensatory Sweating ◽  
Content Type ◽  
Postoperative Changes ◽  
The Face ◽  
The Difference ◽  
Fine Print

Object. Transthoracic endoscopic T2–3 sympathectomy is currently the treatment of choice for palmar hyperhidrosis. Compensatory sweating of the face, trunk, thigh, and sole of the foot was found in more than 50% of patients who underwent this procedure. The authors conducted this study to investigate the associated intraoperative changes in plantar skin temperature and postoperative plantar sweating. Methods. One hundred patients with palmar hyperhidrosis underwent bilateral transthoracic endoscopic T2–3 sympathectomy. There were 60 female and 40 male patients who ranged in age from 13 to 40 years (mean age 21.6 years). Characteristics studied included changes in palmar and plantar skin temperature measured intraoperatively, as well as pre- and postoperative changes in plantar sweating and sympathetic skin responses (SSRs). In 59 patients (59%) elevation of plantar temperature was demonstrated at the end of the surgical procedure. In this group, plantar sweating was found to be exacerbated in three patients (5%); plantar sweating was improved in 52 patients (88.1%); and no change was demonstrated in four patients (6.8%). In the other group of patients in whom no temperature change occurred, increased plantar sweating was demonstrated in three patients (7.3%); plantar sweating was improved in 20 patients (48.8%); and no change was shown in 18 patients (43.9%). The difference between temperature and sweating change was significant (p = 0.001). Compared with the presympathectomy rate, the rate of absent SSR also significantly increased after sympathectomy: from 20 to 76% after electrical stimulation and 36 to 64% after deep inspiration stimulation, respectively (p < 0.05). Conclusions. In contrast to compensatory sweating in other parts of the body after T2–3 sympathetomy, improvement in plantar sweating was shown in 72% and worsened symptoms in 6% of patients. The intraoperative plantar skin temperature change and perioperative SSR demonstrated a correlation between these changes.

Age-related changes in the proportion of intracranial cerebrospinal fluid space measured using volumetric computerized tomography scanning

2002 ◽  
Vol 97 (3) ◽  
pp. 607-610 ◽  
Author(s):  
Hiroshi Wanifuchi ◽  
Takashi Shimizu ◽  
Takashi Maruyama
Keyword(s):  
Cerebrospinal Fluid ◽  
Computerized Tomography ◽  
Ct Scanning ◽  
Volume Measurement ◽  
Intracranial Volume ◽  
Content Type ◽  
Standard Curve ◽  
Age Related ◽  
Fine Print ◽  
Age Related Changes

Object. The purpose of this study was to establish a standard curve to demonstrate normal age-related changes in the proportion of intracranial cerebrospinal fluid (CSF) space in intracranial volume (ICV) during each decade of life. Methods. Using volumetric computerized tomography (CT) scanning and computer-guided volume measurement software, ICV and cerebral parenchymal volume (CPV) for each decade of life were measured and the intracranial CSF ratio was calculated by the following formula: percentage of CSF = (ICV − CPV)/ICV × 100%. The standard curve for age-related changes in normal percentages of intracranial CSF was obtained. Conclusions. Based on this standard curve, the percentage of intracranial CSF rapidly increased after the sixth decade, seeming to reflect the brain atrophy that accompanies increased age.

External carotid-cavernous sinus fistula diagnosed by common carotid arteriography

1974 ◽  
Vol 41 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Louis Wener ◽  
Giovanni Di Chiro ◽  
Robert A. Mendelsohn
Keyword(s):  
Cavernous Sinus ◽  
Carotid Arteries ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Cavernous Sinus Fistula ◽  
The Difference ◽  
Fine Print

✓ An external carotid-cavernous fistula diagnosed by serial common carotid arteriography is reported. The diagnosis was reached on the basis of the difference in time between filling of the distal internal and external carotid arteries and the visualization of the fistula.

Sign in / Sign up

Export Citation Format

Share Document