Linear CT-scan measurements in alcohol-dependent patients with and without delirium tremens

The aims of the present study were to examine whether chronic alcohol dependence and the development of delirium tremens are characterized by changes in linear CT measurements of brain liquor spaces and intracranial distances indicative of prefrontal atrophy, and frontal (sub)cortical or temporal (sub)cortical atrophy. Toward this end linear measurements were performed in 47 alcohol dependent patients with and without a history of delirium tremens and in 10 healthy volunteers using CT-scanning. The following linear measurements were calculated: (1) the Evans ratio; (2) the cella media index (CMI); (3) the maximum width of the third ventricle; (4) the maximum width of the fourth ventricle; (5) the maximum frontal subarachnoid space (MFSS); (6) the maximum width of the anterior interhemispheric fissure (MIF), and (7) the maximum width of the Sylvian fissure (MSF). The alcoholics were divided into subgroups according to the Münchner Alkoholismus Test (MALT) and the presence of delirium tremens. The MFSS of the alcohol-dependent patients was significantly larger than that of the controls. The MIF and MSF of high MALT scorers were significantly larger than those of low scorers and controls. Alcohol-dependent patients with a known history of delirium tremens had significantly larger MIF and MSF than did patients without delirium tremens and controls. The results suggest that alcohol dependence is characterized by prefrontal atrophy, and that frontal cortical and temporal (sub)cortical atrophy may be related to the development of delirium tremens.