title: In normal aging ventricular system never attains pathological values of Evans' index.
abstract: Ventricular enlargement in normal aging frequently forces the radiological diagnosis of hydrocephalus, but the reliability of Evans' index as a radiological marker of abnormal ventricular enlargement (values > 0.30) during aging is not assessed. Here we analyze ventricular size during aging and the reliability of Evans' index as a radiological marker of abnormal ventricular enlargement. We calculated Evans' index in the axial Computed Tomography scans of 1221 consecutive individuals (aged 45-101 years) from an emergency department. Stratified analysis of one-year cohorts showed that the mean Evans' index value per class was invariably < 0.30. Roughly one out five Computed Tomography scans was associated with Evans' index values > 0.30 and Evans' index values increased with age. The risk of having an Evans' index value > 0.30 increased by 7.8% per year of age (p < 0.001) and males were at 83.9% greater risk than females (p < 0.001). Overall, this study shows that normal aging enlarges the ventricular system, but never causes abnormal ventricular enlargement. Evans' index values > 0.30 should reflect an underlying neurological condition in every individual.
authors.affiliation: Department of Neurology and Psychiatry, Neurosurgery, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Missori
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Aurelia
authors.initials: A
authors.lastname: Rughetti
authors.affiliation: Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Peschillo
authors.affiliation: Department of Radiology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Gualdi
authors.affiliation: Department of Radiology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Di Biasi
authors.affiliation: Department of Public Health and Infectious Diseases, Medical Statistics and Biometry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Italo
authors.initials: I
authors.lastname: Nofroni
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Marinelli
authors.affiliation: Department of Neurology and Psychiatry, Neurosurgery, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fattapposta
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Neurology, A. Fiorini Hospital, Terracina, LT, "Sapienza" University of Rome, Polo Pontino, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Currà
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
keywords: Evans’ index; Gerotarget; aging; brain; enlargement; ventricular system