Comparison of Anterior Lateral Ventricular Index with Evans Index, Callosal Angle, and Disproportionately Enlarged Subarachnoid-space Hydrocephalus in Postoperative Evaluation of Idiopathic Normal Pressure Hydrocephalus
Neurologia Medico-Chirurgica, cilt.66, sa.3, ss.145-151, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 66 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.2176/jns-nmc.2025-0250
- Dergi Adı: Neurologia Medico-Chirurgica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.145-151
- Anahtar Kelimeler: idiopathic normal pressure hydrocephalus, anterior lateral ventricular index, Evans Index, callosal angle, DESH
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
This study aimed to compare the anterior lateral ventricular index with established radiological markers, including the Evans Index, callosal angle, and disproportionately enlarged subarachnoid-space hydrocephalus, in evaluating postoperative radiological improvement in patients with idiopathic normal pressure hydrocephalus. A retrospective analysis was conducted on 46 patients who underwent ventriculoperitoneal shunt surgery between January 2019 and February 2025. Pre- and postoperative cranial computed tomography and magnetic resonance imaging scans were used to measure Evans Index, anterior lateral ventricular index, callosal angle and the presence of disproportionately enlarged subarachnoid-space hydrocephalus was assessed. Clinical parameters, including gait performance (10-meter walking and 360° turning steps) and urinary continence, were compared with radiological changes. Both Evans Index and anterior lateral ventricular index significantly decreased postoperatively (Evans Index: 0.388→0.336, p < 0.001; anterior lateral ventricular index: 0.552→0.479, p < 0.001), while callosal angle significantly increased (85.3°→99.7°, p < 0.05). Anterior lateral ventricular index reduction correlated moderately with Evans Index reduction (r = 0.37, p = 0.011) and weakly with callosal angle increase (r = 0.26, p = 0.080). Gait performance improved significantly (p < 0.001), and urinary incontinence resolved in 40.9% of affected patients. Anterior lateral ventricular index reduction showed stronger correlations with gait improvement (r = −0.45, p = 0.002) and continence recovery (r = −0.33, p = 0.024) compared with Evans Index or callosal angle. Disproportionately enlarged subarachnoid-space hydrocephalus positivity was not significantly associated with postoperative outcomes. These findings suggest that anterior lateral ventricular index may provide a more sensitive and clinically relevant linear measure than traditional indices and can serve as a complementary parameter to Evans Index and callosal angle in the postoperative evaluation of idiopathic normal pressure hydrocephalus.