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Comparative CT Ventricular Morphometrics in Hydrocephalus, Stroke, and Traumatic Brain Injury: A

Andrada-Iasmina Roşu1,2, Laura Andreea Ghenciu3,4, Ovidiu Alin Haţegan5

  • 1Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.

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Summary

CT scans can identify ventricular enlargement to distinguish hydrocephalus from stroke and traumatic brain injury. Ventricular morphometrics, especially Evans index and third ventricle width, improve diagnostic accuracy when accounting for intracranial distortion.

Keywords:
Evans indexcomputed tomographyhydrocephalusstrokethird ventricle widthtraumatic brain injuryventricular morphometricsventriculomegaly

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Ventricular enlargement is a common finding in acute neurological conditions like hydrocephalus, stroke, and traumatic brain injury (TBI).
  • Distinguishing these conditions based solely on non-contrast computed tomography (CT) can be challenging.

Purpose of the Study:

  • To evaluate if CT-based ventricular morphometric parameters can differentiate hydrocephalus from stroke and TBI.
  • To assess the diagnostic performance of these parameters in initial neuroimaging examinations.

Main Methods:

  • Retrospective observational study of 186 adult patients (hydrocephalus, stroke, TBI).
  • Quantitative analysis of ventricular parameters: Evans index, third ventricle width, temporal horn dilation, periventricular edema.
  • Development of logistic regression models (primary morphometric and distortion-controlled) and ROC curve analysis.

Main Results:

  • Hydrocephalus patients exhibited significantly greater ventricular enlargement (higher Evans index and third ventricle width).
  • The primary morphometric model showed moderate discrimination (AUC 0.71).
  • The distortion-controlled model significantly improved diagnostic performance (AUC 0.91), with Evans index and third ventricle width as key predictors.

Conclusions:

  • CT-derived ventricular morphometrics offer a practical method for differentiating hydrocephalus from stroke and TBI on initial CT scans.
  • Incorporating intracranial distortion variables enhances diagnostic accuracy, supporting objective interpretation in neuroimaging.