Keywords
How to Cite
Abstract
Background: The most clinically applied linear measures in routine reporting of the cranial CT are the max transverse widths of the frontal, temporal and occipital horns of the lateral cerebral ventricles and each of these measures are taken bilaterally as distinct right and left values. The right frontal horn width is a CT-based measure of central ventricular expansion and proximity to the caudate, while the left frontal horn width is also a CT measure of central expansion and proximity to the caudate; the right and left temporal horn widths are CT-based measures of medial temporal lobe volume; and the right and left occipital horn widths are CT-based measures of posterior ventricular expansion. Further, the Evans Index is a derived ratio based on the maximum frontal horn width and is used widely as a tool to diagnose normal pressure hydrocephalus. Normative CT reference values of these parameters for adults of Pakistan are not available although all six bilateral measurements vary with age and differ between sexes. Objective: To create age and sex stratified normative CT reference values of right and left frontal, temporal and occipital horn widths of lateral cerebral ventricles in healthy Pakistani adult population and to determine the effects of age and sex on these bilateral measurements. Methods: This was a prospective cross-sectional study at Idrees Hospital, Sialkot, Pakistan for a period of six months. One hundred and forty healthy adults (70 males & 70 females) in the age range of 18-80 years were enrolled by convenient sampling, further divided into seven age groups (consisting of 10 subjects in each group) of 10 subjects per sex. Results: Overall mean widths of 140 healthy Pakistani adults (70 males and 70 females) aged between 18 and 80 years varied from 5.2 to 5.8 mm for the six bilateral horn measurements. The age had a very high and significant positive correlation with all six parameters (Spearman's r ranging from 0.913 to 0.945, p < 0.001). No statistically significant difference was found between sexes for any of the six measurements (all p > 0.05). The right temporal horn was much larger than the left (Z = −3.807, p < 0.001) but not significantly different from the left for the frontal and occipital horns. Conclusion: This study provides the first age- and sex-stratified normative reference values of bilateral frontal, temporal and occipital horn width of lateral ventricles in healthy adult population of Pakistan. All horn widths show a strong positive correlation with age, are not sex dependent and show an anatomical right to left difference in the temporal horns that can be measured as a normal variant. These reference values should guide the regular reporting and screening of cranial computed tomography in Pakistan.