Ces radiol. 2008, 62(4):388-394

III. ventricle size and its floor: geometric study from the point of view of neuroendoscopyOriginal article

Jan Chrastina¹, Zdeněk Novák¹, Ivo Říha^1,2, Věra Feitová³, Helena Koutková⁴

¹ Neurochirurgická klinika LF MU a FN u sv. Anny v Brně

² Ústav biomedicínského inženýrství FEKT VUT, Brno

³ Klinika zobrazovacích metod LF MU a FN u sv. Anny v Brně

⁴ Katedra matematiky a deskriptivní geometrie FAST VUT, Brno

Aim: The following parameters were defined for hydrocephalus diagnostics and neuroendoscopic surgeries planning - CA-CP (intercommissural distance), H (the height of the third ventricle), IMD (intermamillary distance) - the distance between the anterior margins of mamillary bodies, reflecting the width of the third ventricle, BA-MB (the distance between basilar bifurcation and mamillary bodies) and BA-DS (the distance between dorsum sellae and basilar bifurcation) defining the safe area for endoscopic third ventriculostomy.

Methods: The values measured during presurgical planning were compared in patients suffering from hydrocephalus (92 patients - 37 females, 55 males) and control group (patients operated on for epilepsy and Parkinson disease, 50 patients - 22 females, 28 males).

Results: Statistically significant increase of CA-CP, IMD and H values in hydrocephalic patients was proven (p < 0.01 - Kolmogorov-Smirnov) when compared with control group. The study did not show significant diference when comparing MB-BA and BA-DS, describing third ventricular floor and defining the safe area for endoscopic third ventriculostomy (BA-DS). Another finding is the variability of basilar bifurcation and mamillary bodies with frequent position of basilar artery in front of mamillary bodies (51.1 % in hydrocephalic patients, 62 % in control group) with surgical importance.

Conclusions: Together with the increase of third ventricle parameters the paper points to the changes of the principal parameter of key importace for stereotactic neurosurgery - CA-CP distance with the possibility of influencing the relationship of deep brain structures to the line in ventriculomegaly. The changes of third ventricular floor were not shown. The variability in the location of basilar artery as related to mamillary bodies is another finding.

Keywords: hydrocephalus, endoscopic third ventriculostomy, third ventricular floor, intercommissural distance

Grants and funding:

Podporováno grantovou studií IGA MZ CR NR/9157-3.

Accepted: August 15, 2008; Published: December 1, 2008  Show citation