Difference between left and right lateral ventricular sizes in neonates

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Abstract

The objective of this study is to determine the causes of asymmetry of the lateral ventricles in neonates. We also studied the effect of head position and the relationship of body weight at birth in regard to lateral ventricular size. Eligible for inclusion in this study were 60 neonatal infants whose gestational age was 33.1±3.5 weeks and whose birth weight was 1793±613 g. Ultrasonographic examinations were performed at the first and the second weeks after birth. In parasagittal and coronal scans through the posterior horn of the lateral ventricle, the lateral ventricle was traced and its area was measured. We found no significant variation of ventricular size in relation to body weight at birth. The left ventricular size was larger than the right one. The difference of the left and right ventricular sizes was partially effected by head position. The ratio of left to right lateral ventricular sizes showed a very wide distribution. We considered that ventricular asymmetry is not pathological, but due to individual differences.

Introduction

Neurosonography is an indispensable examination tool for use during the neonatal period. Measurement of the cerebral ventricular size is important in the diagnosis of hydrocephalus or cerebral atrophy.

Many reports have addressed the size of the cerebral ventricles. Levene [1] reported that the lateral ventricles grow according to the gestational age; however, Saliba et al. [2] found no significant variation of ventricular size in relation to gestational age. A few reports [3], [4], [5] have described asymmetry of the ventricles in neonates. In most cases of asymmetry described in these reports, the left ventricle was larger than the right; however, the etiology of the ventricular asymmetry was unknown.

The objective of the present study is to determine the causes of asymmetry of the lateral ventricles in neonates. We also studied the effect of head position and the relationship of gestational age to the lateral ventricular size.

Section snippets

Materials and methods

Eligible for inclusion in this study were 60 neonatal infants admitted to the neonatal intensive care unit (NICU). Their gestational age was 33.1±3.5 weeks and their birth weight was 1793±613 g. Gestational age was determined based on maternal dates and the scoring system developed by Dubowitz et al. [6]. Fourteen cases had mild asphyxia (their Apgar scores were from 4 to 7). Twenty-five cases of transient tachypnea of the newborn, eight cases of respiratory distress syndrome, two cases of mild

Results

At the first and the second examinations, the left side of the head was the upper side in 33 and 38 infants, respectively, while the right side of the head was the upper side in 27 and 22 infants. There was no difference in head positions among the groups.

No statistical difference was seen in the size of the ventricles in regard to the presence or absence of asphyxia, transient tachypnea of the newborn, respiratory distress syndrome, pneumothorax and twins. The lateral ventricular size became

Discussion

It is difficult to evaluate ventricle size because of the complexity of the shape of the ventricular system. In most papers describing ventricular size [1], [2], [3], [4], [5], the width or the area of a lateral ventricular body was measured. However, it has been reported that a lateral cerebral ventricle dilates asymmetrically in premature patients with hydrocephalus and that the most rapid rate of growth was in the posterior region [7]. Therefore, it is more important to evaluate the size of

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