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ORIGINAL RESEARCH ADULT BRAIN Ventricular Volume Is More Strongly Associated with Clinical Improvement Than the Evans Index after Shunting in Idiopathic Normal Pressure Hydrocephalus J. Neikter, S. Agerskov, P. Hellström, M. Tullberg, G. Starck, D. Ziegelitz, and D. Farahmand ABSTRACT BACKGROUND AND PURPOSE: Ventricular enlargement in idiopathic normal pressure hydrocephalus is often estimated using the Evans index. However, the sensitivity of the Evans index to estimate changes in ventricular size postoperatively has been ques- tioned. Here, we evaluated the postoperative change in ventricle size in relation to shunt response in patients with idiopathic nor- mal pressure hydrocephalus, by comparing ventricular volume and the Evans index. MATERIALS AND METHODS: Fifty-seven patients with idiopathic normal pressure hydrocephalus underwent high-resolution MR imaging preoperatively and 6 months after shunt insertion. Clinical symptoms of gait, balance, cognition, and continence were assessed according to the idiopathic normal pressure hydrocephalus scale. The ventricular volume of the lateral and third ventricles and the Evans index were measured using ITK-SNAP software. Semiautomatic volumetric analysis was performed, and postopera- tive changes in ventricular volume and the Evans index and their relationships to postoperative clinical improvement were compared. RESULTS: The median postoperative ventricular volume decrease was 25 mL (P ,
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Jul 1, 2020
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