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Estimated ventricle size using Evans index: reference values from a population-based sample.

D Jaraj1,2,3, K Rabiei1,3, T Marlow1,2

  • 1Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.

European Journal of Neurology
|January 5, 2017
PubMed
Summary
This summary is machine-generated.

The Evans index, used for diagnosing idiopathic normal-pressure hydrocephalus (iNPH), shows a wide range of values in older adults. Many individuals over 70 exhibit ventricular enlargement based on current diagnostic criteria.

Keywords:
Evans indexdementiaepidemiologyidiopathic normal-pressure hydrocephalusreference valuesventricular enlargement

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Area of Science:

  • Neurology
  • Radiology
  • Epidemiology

Background:

  • The Evans index estimates ventricular size for diagnosing idiopathic normal-pressure hydrocephalus (iNPH).
  • Current diagnostic guidelines for iNPH require Evans index values >0.3.
  • Normal Evans index values in adults are not well-established due to a lack of epidemiological studies.

Purpose of the Study:

  • To establish reference values for the Evans index in an elderly population.
  • To gather descriptive data on the Evans index in individuals aged 70 years and older.

Main Methods:

  • A population-based sample of 1235 men and women aged ≥70 years was studied.
  • Participants included individuals from both private households and residential care.
  • Neuropsychiatric examinations and head computed tomography (CT) were conducted between 1986 and 2000.

Main Results:

  • Evans index values ranged from 0.11 to 0.46, with a mean of 0.28 (SD, 0.04) in the total sample.
  • 20.6% of participants (n=255) had Evans index values >0.3.
  • Individuals with dementia and those with radiological signs of iNPH showed higher mean Evans index values (0.31 and 0.36, respectively).

Conclusions:

  • A significant proportion of older adults exceed the pathological threshold for ventricular enlargement based on current Evans index criteria.
  • Clinicians and researchers should be aware of the broad spectrum of Evans index values in the elderly population.
  • These findings highlight the need for careful interpretation of the Evans index in older individuals, particularly when diagnosing iNPH.