The Correlation Between Lateral Ventricle Asymmetry and Cerebral Blood Flow: Implications for Stroke Risk

Background: This study explored the correlation between lateral ventricle volume asymmetry and cerebral blood flow (CBF). Methods: A retrospective review of 94 patients who underwent CT perfusion (CTP) and standard brain imaging was conducted. Lateral ventricle volumes and CBF across 13 vascular-based regions of interest (ROIs) were measured. Cerebral artery stenosis was identified using magnetic resonance angiography (MRA) and digital subtraction angiography (DSA). Paired t-tests, Pearson's correlation, logistic regression, and Cox models were used to assess the relationships between lateral ventricle asymmetry, CBF differences, and their associations with cerebral artery stenosis and the risk of stroke during follow-up. Results: 94 patients were included (mean age: 60.7 years). CBF was significantly lower on the side of the larger lateral ventricle in regions supplied by the anterior cerebral artery (ACA) (Mean relative value ± SD, % = 112.3 ± 32.5, p-value = 0.0016) and middle cerebral artery (MCA) (Mean relative value ± SD, % = 123.1 ± 57.8, p-value = 0.0004). A moderate correlation was observed between lateral ventricle volume asymmetry and CBF differences across the entire cohort. Significant associations were identified between CBF differences in specific ROIs and the presence of cerebral artery stenosis (MCA: aOR = 1.026, 95% CI: 1.004-1.048, p-value = 0.019). Conclusions: Lateral ventricle asymmetry is associated with reduced CBF in specific brain regions, particularly those supplied by the ACA. CBF differences in regions supplied by the PCA are linked to increased risk of subsequent stroke during follow-up.