Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury

Arnold Tóth, Ilona Schmalfuss, Shelley C. Heaton, Andrea Gabrielli, H. Julia Hannay, Linda Papa, Gretchen M. Brophy, Kevin K W Wang, A. Büki, Attila Schwarcz, Ronald L. Hayes, Claudia S. Robertson, Steven A. Robicsek

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Midline shift following severe traumatic brain injury (sTBI) detected on computed tomography (CT) scans is an established predictor of poor outcome. We hypothesized that lateral ventricular volume (LVV) asymmetry is an earlier sign of developing asymmetric intracranial pathology than midline shift. This retrospective analysis was performed on data from 84 adults with blunt sTBI requiring a ventriculostomy who presented to a Level I trauma center. Seventy-six patients underwent serial CTs within 3h and an average of three scans within the first 10d of sTBI. Left and right LVVs were quantified by computer-assisted manual volumetric measurements. LVV ratios (LVR) were determined on the admission CT to evaluate ventricular asymmetry. The relationship between the admission LVR value and subsequent midline shift development was tested using receiver operating characteristic (ROC) analysis, and odds ratio (OR) and relative risk tests. Sixty patients had no >5mm midline shift on the initial admission scan. Of these, 15 patients developed it subsequently (16 patients already had >5mm midline shift on admission scans). For >5mm midline shift development, admission LVR of >1.67 was shown to have a sensitivity of 73.3% and a specificity of 73.3% (area under the curve=0.782; p1.67 as exposure yielded an OR of 7.56 (p

Original languageEnglish
Pages (from-to)1307-1311
Number of pages5
JournalJournal of Neurotrauma
Volume32
Issue number17
DOIs
Publication statusPublished - Sep 1 2015

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Lateral Ventricles
Odds Ratio
Tomography
Ventriculostomy
Trauma Centers
ROC Curve
Area Under Curve
Pathology
Traumatic Brain Injury

Keywords

  • computed tomography
  • midline shift
  • traumatic brain injury
  • ventricle

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Tóth, A., Schmalfuss, I., Heaton, S. C., Gabrielli, A., Hannay, H. J., Papa, L., ... Robicsek, S. A. (2015). Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury. Journal of Neurotrauma, 32(17), 1307-1311. https://doi.org/10.1089/neu.2014.3696

Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury. / Tóth, Arnold; Schmalfuss, Ilona; Heaton, Shelley C.; Gabrielli, Andrea; Hannay, H. Julia; Papa, Linda; Brophy, Gretchen M.; Wang, Kevin K W; Büki, A.; Schwarcz, Attila; Hayes, Ronald L.; Robertson, Claudia S.; Robicsek, Steven A.

In: Journal of Neurotrauma, Vol. 32, No. 17, 01.09.2015, p. 1307-1311.

Research output: Contribution to journalArticle

Tóth, A, Schmalfuss, I, Heaton, SC, Gabrielli, A, Hannay, HJ, Papa, L, Brophy, GM, Wang, KKW, Büki, A, Schwarcz, A, Hayes, RL, Robertson, CS & Robicsek, SA 2015, 'Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury', Journal of Neurotrauma, vol. 32, no. 17, pp. 1307-1311. https://doi.org/10.1089/neu.2014.3696
Tóth A, Schmalfuss I, Heaton SC, Gabrielli A, Hannay HJ, Papa L et al. Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury. Journal of Neurotrauma. 2015 Sep 1;32(17):1307-1311. https://doi.org/10.1089/neu.2014.3696
Tóth, Arnold ; Schmalfuss, Ilona ; Heaton, Shelley C. ; Gabrielli, Andrea ; Hannay, H. Julia ; Papa, Linda ; Brophy, Gretchen M. ; Wang, Kevin K W ; Büki, A. ; Schwarcz, Attila ; Hayes, Ronald L. ; Robertson, Claudia S. ; Robicsek, Steven A. / Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury. In: Journal of Neurotrauma. 2015 ; Vol. 32, No. 17. pp. 1307-1311.
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