Pediatric Radiology

, Volume 40, Issue 10, pp 1651–1656 | Cite as

Cerebral biometry at birth and at 4 and 8 months of age. A prospective study using US

  • Joost Gravendeel
  • Karen Rosendahl
Original Article



Although longitudinal reference intervals for ventricular size are crucial for the diagnosis of dilated ventricles, such data are sparse.


To establish references for ventricular measurements at birth, and at 4 and 8 months follow-up, and to examine the inter-observer variation of the measurements.

Materials and methods

This prospective, longitudinal study included 120 term newborns (boys 65, girls 55), mean age 1.5 days on initial scans, with re-examination at 4 months and 8 months of age. One examiner performed all the examinations, measuring: ventricular index, frontal horn width, third ventricle width, frontal subarachnoid space depth, optic nerve sheath diameter and resistive index.


One hundred eight (90%) and 90 (75%) of the infants, respectively, attended for follow-up at 4 and 8 months of age. All measures increased with age, except for the depth of the subarachnoid spaces that showed an initial rise, followed by a mild drop at 8 months, and for the resistive index that remained stable at 0.6. The increase was particularly significant for frontal horn width with an increase from 2.2 mm at birth to 6.5 mm at 4 months in boys, and 2.1–5.8 mm in girls. The agreement between two observers was fair to moderate for most of the measurements.


The increase in the width of the frontal horns between birth and 4 months of age, as well as the wide normal range found among all three age groups are noteworthy and should inform future diagnostics.


Brain imaging Reference range US Neonate 


  1. 1.
    Gilmore JH, van Tol J, Kliewer MA et al (1998) Mild ventriculomegaly detected in utero with ultrasound: clinical associations and implications for schizophrenia. Schizophr Res 33:133–140CrossRefPubMedGoogle Scholar
  2. 2.
    Gilmore JH, Smith LC, Wolfe HM et al (2008) Prenatal mild ventriculomegaly predicts abnormal development of the neonatal brain. Biol Psychiatry 64:1069–1076CrossRefPubMedGoogle Scholar
  3. 3.
    Sanderson TL, Best JJ, Doody GA et al (1999) Neuroanatomy of comorbid schizophrenia and learning disability: a controlled study. Lancet 354:1867–1871CrossRefPubMedGoogle Scholar
  4. 4.
    Piven J, Arndt S, Bailey J et al (1995) An MRI study of brain size in autism. Am J Psychiatry 152:1145–1149PubMedGoogle Scholar
  5. 5.
    Prassopoulos P, Cavouras D, Ioannidou M et al (1996) Study of subarachnoid spaces in children with idiopathic mental retardation. J Child Neurol 11:197–200CrossRefPubMedGoogle Scholar
  6. 6.
    Lawrie SM, Abukmeil SS (1998) Brain abnormality in schizophrenia. A systematic and quantitative review of volumetric magnetic resonance imaging studies. Br J Psychiatry 172:110–120CrossRefPubMedGoogle Scholar
  7. 7.
    Swayze VW 2nd, Johnson VP, Hanson JW et al (1997) Magnetic resonance imaging of brain anomalies in fetal alcohole syndrome. Pediatrics 99:232–240CrossRefPubMedGoogle Scholar
  8. 8.
    Levene MI (1981) Measurement of the growth of the lateral ventricles in preterm infants with real-time ultrasound. Arch Dis Child 56:900–904CrossRefPubMedGoogle Scholar
  9. 9.
    Davies MW, Swaminathan M, Chuang SL et al (2000) Reference ranges for the linear dimensions of the intracranial ventricles in preterm neonates. Arch Dis Child Fetal Neonatal Ed 82:F218–F223CrossRefPubMedGoogle Scholar
  10. 10.
    Armstrong DL, Bagnall C, Harding JE et al (2002) Measurement of the subarachnoid space by ultrasound in preterm infants. Arch Dis Child Fetal Neonatal Ed 86:F124–F126CrossRefPubMedGoogle Scholar
  11. 11.
    Sondhi V, Gupta G, Gupta PK et al (2008) Establishment of nomograms and reference ranges for intra-cranial ventricular dimensions and ventriculo-hemispheric ratio in newborns by ultrasonography. Acta Paediatr 97:738–744CrossRefPubMedGoogle Scholar
  12. 12.
    McArdle CB, Richardson CJ, Nicholas DA et al (1987) Developmental features of the neonatal brain: MR imaging. Part II. Ventricular size and extracerebral space. Radiology 162:230–234PubMedGoogle Scholar
  13. 13.
    Lui K, Boaq G, Daneman A et al (1990) Widened subarachnoid space in pre-discharge cranial ultrasound: evidence of cerebral atrophy in immature infants? Dev Med Child Neurol 32:882–887CrossRefPubMedGoogle Scholar
  14. 14.
    Shah PS, Sarvaiya JB, Rawal JR et al (1992) Normal ventricular size and ventriculo-hemispheric ratio in infants upto 6 months of age by cranial ultrasonography. Indian Pediatr 29:439–442PubMedGoogle Scholar
  15. 15.
    Libicher M, Tröger J (1992) US measurement of the subarachnoid space in infants: normal values. Radiology 184:749–751PubMedGoogle Scholar
  16. 16.
    Lam WW, Ai VH, Wong V et al (2001) Ultrasonographic measurement of subarachnoid space in normal infants and children. Pediatr Neurol 25:380–384CrossRefPubMedGoogle Scholar
  17. 17.
    Iova A, Garmashov A, Androuchtchenko N et al (2004) Evaluation of the ventricular system in children using transcranial ultrasound: reference values for routine diagnostics. Ultrasound Med Biol 30:745–751CrossRefPubMedGoogle Scholar
  18. 18.
    Helmke K, Hansen HC (1996) Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension. Part I: Experimental study. Pediatr Radiol 26:701–705CrossRefPubMedGoogle Scholar
  19. 19.
    Helmke K, Hansen HC (1996) Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension. Part II: Patient study. Pediatr Radiol 26:706–710CrossRefPubMedGoogle Scholar
  20. 20.
    Helmke K, Winkler P (1987) Sonographically determined normal values of the intracranial ventricular system in the first year of life. Monatsschr Kinderheilkd 135:148–152PubMedGoogle Scholar
  21. 21.
    London DA, Carroll BA, Enzmann DR (1980) Sonography of ventricular size and germinal matrix hemorrhage in premature infants. AJR 135:559–564PubMedGoogle Scholar
  22. 22.
    Altman DG (1991) Practical statistics for medical research, 1st edn. Chapman and Hall, LondonGoogle Scholar
  23. 23.
    Folkehelseinstituttet (2009) [Medisinsk fødselsregisters statistikkbank]
  24. 24.
    Nelson MD, Tavare CJ, Petrus L et al (2003) Changes in the size of the lateral ventricles in the normal-term newborn following vaginal delivery. Pediatr Radiol 33:831–835CrossRefPubMedGoogle Scholar
  25. 25.
    Roovers EA, Boere-Boonekamp MM, Geertsma TS et al (2003) Ultrasonographic screening for developmental dysplasia of the hip in infants. Reproducibility of assessments made by radiographers. J Bone Joint Surg Br 85:726–730PubMedGoogle Scholar
  26. 26.
    Aukland SM, Odberg MD, Gunny R et al (2008) Assessing ventricular size: is subjective evaluation accurate enough? New MRI-based normative standards for 19-year-olds. Neuroradiology 50:1005–1011CrossRefPubMedGoogle Scholar
  27. 27.
    Korber F, Scharf M, Moritz J et al (2005) Sonography of the optical nerve—experience in 483 children. Rofo 177:229–235PubMedGoogle Scholar
  28. 28.
    Beare NA, Kampondeni S, Glover SJ et al (2008) Detection of raised intracranial pressure by ultrasound measurement of optic nerve sheath diameter in African children. Trop Med Int Health 13:1400–1404CrossRefPubMedGoogle Scholar
  29. 29.
    McAuley D, Paterson A, Sweeney L (2009) Optic nerve sheath ultrasound in the assessment of paediatric hydrocephalus. Childs Nerv Syst 25:87–90CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of RadiologyUniversitair Medisch Centrum GroningenGroningenThe Netherlands
  2. 2.Department of Surgical SciencesUniversity of BergenBergenNorway
  3. 3.Diagnostic RadiologyGreat Ormond Street Hospital for ChildrenLondonUK

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