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<meta name="DC.Title" content="Atrophic Enlargement of CSF Volume after Subarachnoid Hemorrhage: Correlation with Neuropsychological Outcome" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1804" />
<meta name="DC.Date" content="2010-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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Indicates open access to non-subscribers at www.ajnr.org" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Ventricular dilation and sulcal enlargement are common sequelae after aSAH. Our aim was to quantify the late ventricular dilation and volumes of the CSF spaces after aSAH and to determine if they correlate with neurologic and cognitive impairments frequently detected in these patients.

MATERIALS AND METHODS: 3D T1-weighted images needed for volumetry were available in 76 patients 1 year after aSAH, along with 75 neuropsychological assessments. Volumes of CSF segments and ICV were quantified by SPM in 76 patients and 30 control subjects to determine CSF/ICV ratios. The mCMI was calculated to roughly evaluate the ventricular dilation. The contributing factors for enlarged ventricles and CSF volumes were reviewed from radiologic, clinical, and neuropsychological perspectives.

RESULTS: The mCMI was higher in patients with aSAH (0.23 ± 0.06) compared with control subjects (0.20 ± 0.04; P = .020). In line with these planimetric measurements, the SPM-based CSF/ICV ratios were higher in patients with aSAH (35.58 ± 7.0) than in control subjects (30.36 ± 6.25; P = .001). Preoperative hydrocephalus, higher HH and Fisher grades, and focal parenchymal lesions on brain MR imaging, but not the treatment technique, were associated with ventricular enlargement. The clinical outcome and presence of neuropsychological deficits correlated significantly with CSF enlargement.

CONCLUSIONS: Ventricular and sulcal enlargement, together with reduced GM volumes, after aSAH may indicate general atrophy rather than hydrocephalus. Enlarged CSF spaces correlate with cognitive deficits after aSAH. A simple measure, mCMI proved to be a feasible tool to assess the diffuse atrophic brain damage after aSAH.

aSAH
:   aneurysmal subarachnoid hemorrhage
EBI
:   early brain injury
GM
:   gray matter
GOS
:   Glasgow Outcome Scale
HH
:   Hunt and Hess
ICV
:   total intracranial volume
mCMI
:   modified cella media index
MNI
:   Montreal Neurologic Institute
MRI
:   MR imaging
SPM
:   statistical parametrical mapping
WM
:   white matter." />
<meta name="DC.Contributor" content="P. Bendel" />
<meta name="DC.Contributor" content="T. Koivisto" />
<meta name="DC.Contributor" content="M. Äikiä" />
<meta name="DC.Contributor" content="E. Niskanen" />
<meta name="DC.Contributor" content="M. Könönen" />
<meta name="DC.Contributor" content="T. Hänninen" />
<meta name="DC.Contributor" content="R. Vanninen" />
<meta name="article:published_time" content="2010-02-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Atrophic Enlargement of CSF Volume after Subarachnoid Hemorrhage: Correlation with Neuropsychological Outcome" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Ventricular dilation and sulcal enlargement are common sequelae after aSAH. Our aim was to quantify the late ventricular dilation and volumes of the CSF spaces after aSAH and to determine if they correlate with neurologic and cognitive impairments frequently detected in these patients.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;3D T1-weighted images needed for volumetry were available in 76 patients 1 year after aSAH, along with 75 neuropsychological assessments. Volumes of CSF segments and ICV were quantified by SPM in 76 patients and 30 control subjects to determine CSF/ICV ratios. The mCMI was calculated to roughly evaluate the ventricular dilation. The contributing factors for enlarged ventricles and CSF volumes were reviewed from radiologic, clinical, and neuropsychological perspectives.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The mCMI was higher in patients with aSAH (0.23 ± 0.06) compared with control subjects (0.20 ± 0.04; &lt;i&gt;P&lt;/i&gt; = .020). In line with these planimetric measurements, the SPM-based CSF/ICV ratios were higher in patients with aSAH (35.58 ± 7.0) than in control subjects (30.36 ± 6.25; &lt;i&gt;P&lt;/i&gt; = .001). Preoperative hydrocephalus, higher HH and Fisher grades, and focal parenchymal lesions on brain MR imaging, but not the treatment technique, were associated with ventricular enlargement. The clinical outcome and presence of neuropsychological deficits correlated significantly with CSF enlargement.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Ventricular and sulcal enlargement, together with reduced GM volumes, after aSAH may indicate general atrophy rather than hydrocephalus. Enlarged CSF spaces correlate with cognitive deficits after aSAH. A simple measure, mCMI proved to be a feasible tool to assess the diffuse atrophic brain damage after aSAH.&lt;/p&gt;" />
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<meta name="citation_author" content="P. Bendel" />
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<meta name="twitter:title" content="Atrophic Enlargement of CSF Volume after Subarachnoid Hemorrhage: Correlation with Neuropsychological Outcome" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Ventricular dilation and sulcal enlargement are common sequelae after aSAH. Our aim was to quantify the late ventricular dilation and volumes of the CSF spaces after aSAH and to determine if they correlate with neurologic and cognitive impairments frequently detected in these patients.

MATERIALS AND METHODS: 3D T1-weighted images needed for volumetry were available in 76 patients 1 year after aSAH, along with 75 neuropsychological assessments. Volumes of CSF segments and ICV were quantified by SPM in 76 patients and 30 control subjects to determine CSF/ICV ratios. The mCMI was calculated to roughly evaluate the ventricular dilation. The contributing factors for enlarged ventricles and CSF volumes were reviewed from radiologic, clinical, and neuropsychological perspectives.

RESULTS: The mCMI was higher in patients with aSAH (0.23 ± 0.06) compared with control subjects (0.20 ± 0.04; P = .020). In line with these planimetric measurements, the SPM-based CSF/ICV ratios were higher in patients with aSAH (35.58 ± 7.0) than in control subjects (30.36 ± 6.25; P = .001). Preoperative hydrocephalus, higher HH and Fisher grades, and focal parenchymal lesions on brain MR imaging, but not the treatment technique, were associated with ventricular enlargement. The clinical outcome and presence of neuropsychological deficits correlated significantly with CSF enlargement.

CONCLUSIONS: Ventricular and sulcal enlargement, together with reduced GM volumes, after aSAH may indicate general atrophy rather than hydrocephalus. Enlarged CSF spaces correlate with cognitive deficits after aSAH. A simple measure, mCMI proved to be a feasible tool to assess the diffuse atrophic brain damage after aSAH.

aSAH
:   aneurysmal subarachnoid hemorrhage
EBI
:   early brain injury
GM
:   gray matter
GOS
:   Glasgow Outcome Scale
HH
:   Hunt and Hess
ICV
:   total intracranial volume
mCMI
:   modified cella media index
MNI
:   Montreal Neurologic Institute
MRI
:   MR imaging
SPM
:   statistical parametrical mapping
WM
:   white matter." />
<meta name="og-title" property="og:title" content="Atrophic Enlargement of CSF Volume after Subarachnoid Hemorrhage: Correlation with Neuropsychological Outcome" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/2/370" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Ventricular dilation and sulcal enlargement are common sequelae after aSAH. Our aim was to quantify the late ventricular dilation and volumes of the CSF spaces after aSAH and to determine if they correlate with neurologic and cognitive impairments frequently detected in these patients.

MATERIALS AND METHODS: 3D T1-weighted images needed for volumetry were available in 76 patients 1 year after aSAH, along with 75 neuropsychological assessments. Volumes of CSF segments and ICV were quantified by SPM in 76 patients and 30 control subjects to determine CSF/ICV ratios. The mCMI was calculated to roughly evaluate the ventricular dilation. The contributing factors for enlarged ventricles and CSF volumes were reviewed from radiologic, clinical, and neuropsychological perspectives.

RESULTS: The mCMI was higher in patients with aSAH (0.23 ± 0.06) compared with control subjects (0.20 ± 0.04; P = .020). In line with these planimetric measurements, the SPM-based CSF/ICV ratios were higher in patients with aSAH (35.58 ± 7.0) than in control subjects (30.36 ± 6.25; P = .001). Preoperative hydrocephalus, higher HH and Fisher grades, and focal parenchymal lesions on brain MR imaging, but not the treatment technique, were associated with ventricular enlargement. The clinical outcome and presence of neuropsychological deficits correlated significantly with CSF enlargement.

CONCLUSIONS: Ventricular and sulcal enlargement, together with reduced GM volumes, after aSAH may indicate general atrophy rather than hydrocephalus. Enlarged CSF spaces correlate with cognitive deficits after aSAH. A simple measure, mCMI proved to be a feasible tool to assess the diffuse atrophic brain damage after aSAH.

aSAH
:   aneurysmal subarachnoid hemorrhage
EBI
:   early brain injury
GM
:   gray matter
GOS
:   Glasgow Outcome Scale
HH
:   Hunt and Hess
ICV
:   total intracranial volume
mCMI
:   modified cella media index
MNI
:   Montreal Neurologic Institute
MRI
:   MR imaging
SPM
:   statistical parametrical mapping
WM
:   white matter." />
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      <h1 class="highwire-cite-title" id="page-title">Atrophic Enlargement of CSF Volume after Subarachnoid Hemorrhage: Correlation with Neuropsychological Outcome</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P. Bendel</span>, <span class="highwire-citation-author" data-delta="1">T. Koivisto</span>, <span class="highwire-citation-author" data-delta="2">M. Äikiä</span>, <span class="highwire-citation-author" data-delta="3">E. Niskanen</span>, <span class="highwire-citation-author" data-delta="4">M. Könönen</span>, <span class="highwire-citation-author" data-delta="5">T. Hänninen</span> and <span class="highwire-citation-author" data-delta="6">R. Vanninen</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">370-376; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1804 </span></div>
  
  
  
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<p id="p-4"><strong>BACKGROUND AND PURPOSE:</strong> Ventricular dilation and sulcal enlargement are common sequelae after aSAH. Our aim was to quantify the late ventricular dilation and volumes of the CSF spaces after aSAH and to determine if they correlate with neurologic and cognitive impairments frequently detected in these patients.</p>
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<p id="p-5"><strong>MATERIALS AND METHODS:</strong> 3D T1-weighted images needed for volumetry were available in 76 patients 1 year after aSAH, along with 75 neuropsychological assessments. Volumes of CSF segments and ICV were quantified by SPM in 76 patients and 30 control subjects to determine CSF/ICV ratios. The mCMI was calculated to roughly evaluate the ventricular dilation. The contributing factors for enlarged ventricles and CSF volumes were reviewed from radiologic, clinical, and neuropsychological perspectives.</p>
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<p id="p-6"><strong>RESULTS:</strong> The mCMI was higher in patients with aSAH (0.23 ± 0.06) compared with control subjects (0.20 ± 0.04; <em>P</em> = .020). In line with these planimetric measurements, the SPM-based CSF/ICV ratios were higher in patients with aSAH (35.58 ± 7.0) than in control subjects (30.36 ± 6.25; <em>P</em> = .001). Preoperative hydrocephalus, higher HH and Fisher grades, and focal parenchymal lesions on brain MR imaging, but not the treatment technique, were associated with ventricular enlargement. The clinical outcome and presence of neuropsychological deficits correlated significantly with CSF enlargement.</p>
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<p id="p-7"><strong>CONCLUSIONS:</strong> Ventricular and sulcal enlargement, together with reduced GM volumes, after aSAH may indicate general atrophy rather than hydrocephalus. Enlarged CSF spaces correlate with cognitive deficits after aSAH. A simple measure, mCMI proved to be a feasible tool to assess the diffuse atrophic brain damage after aSAH.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">aSAH<span class="def-item-dt-sep"></span></dt><dd>aneurysmal subarachnoid hemorrhage<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">EBI<span class="def-item-dt-sep"></span></dt><dd>early brain injury<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">GM<span class="def-item-dt-sep"></span></dt><dd>gray matter<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">GOS<span class="def-item-dt-sep"></span></dt><dd>Glasgow Outcome Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">HH<span class="def-item-dt-sep"></span></dt><dd>Hunt and Hess<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">ICV<span class="def-item-dt-sep"></span></dt><dd>total intracranial volume<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">mCMI<span class="def-item-dt-sep"></span></dt><dd>modified cella media index<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">MNI<span class="def-item-dt-sep"></span></dt><dd>Montreal Neurologic Institute<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">MRI<span class="def-item-dt-sep"></span></dt><dd>MR imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">SPM<span class="def-item-dt-sep"></span></dt><dd>statistical parametrical mapping<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">WM<span class="def-item-dt-sep"></span></dt><dd>white matter.</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-3">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/2/370.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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