Post-Hemorrhagic Hydrocephalus — Ventricular Size — Clinical Pathway: ICU

Post-Hemorrhagic Hydrocephalus in Pre-Term Infants Clinical Pathway — N/IICU

Measuring Ventricular Size on Cranial Ultrasound

Research shows that images obtained using ultrasound are as clinically useful as those obtained using CT or MRI. Cranial ultrasound from referring hospitals should include both of the following measurements when possible.

Frontal-Occipital Horn Ratio (FOR)

FOR = (A+B)/2C and is calculated using the labeled measurements.

  • A = Widest distance across frontal horns (at level of foramen of Monro)
  • B = Widest distance across occipital horns (FOR)
  • C = Widest biparietal diameter

Calculate FOR on multiple slices, and use maximal FOR for clinical decision making.

FOR widest value for each can be on different images

*from CORONAL cine’ loops

Normative Absolute Values

  • Normal = 0.4
  • Mild HC = 0.55
  • Moderate HC = 0.60
  • Severe HC = 0.7
  • Good inter-rater reliability (> 0.9)

 

Frontal and Temporal Horn Ratio (FTHR)

FTHR = A+B/2C

  • A = Widest distance across frontal horns
  • B = Widest distance across temporal horns
  • C = Broadest skull diameter at level of foramen Monro

Correlates highly with volumetric determinations

FTHR all measured at foramen of Monro in one image


*from CORONAL cine’ loops
 

Measurement of Ventricular Size: Reliability of the Frontal and Occipital Horn Ratio Compared to Subjective Assessment  

Frontal and Occipital Horn Ratio: A Linear Estimate of Ventricular Size for Multiple Imaging Modalities in Pediatric Hydrocephalus  

The Frontal and Temporal Horn Ratio to Assess Dimension of Paediatric Hydrocephalus: a Comparative Volumetric Study