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• W1746599802 abstract "Most brain tumours and other intracranial space-occupying lesions so crowd the affected cerebral hemisphere that it bulges to the healthy side. The ventricles shift with respect to the sagittal plane of the skull, and the lateral ventricle of the affected hemisphere usually will be found to be smaller than that of the normal hemisphere. The degree of shifting is ordinarily judged by the position of the septum pellucidum. Conversely, in an atrophic process one may sometimes see a shift of the ventricles to the affected side and here again the position of the septum pellucidum is usually taken as an index of the severity of the lesion. Asymmetry of the skull and rotation due to improper positioning are factors to be eliminated in each case before deciding that the shift is a real one. It is not generally appreciated that ventricular shifts may appear in pneumoencephalograms in the absence of causative space-occupying or atrophic lesions. Displacements of such a nature, which should be recognized as clinically non-significant, form the subject of this paper. Representative cases fall into three broad groups: first, those with unequal filling of the lateral ventricles; second, those associated with subdural gas; third, those encountered in a follow-up examination after twenty-four hours or more. Group I: Non-Significant Ventricular shift with Unequal Filling of the Lateral Ventricles In the average encephalographic study there is shown in the initial frontal view approximately equal filling of the lateral ventricles. Inequality of filling, with displacement to the side of the smaller ventricle, should arouse suspicion of collapse of the latter from a technical fault in the procedure. A possible cause for such a happening may be the removal of a considerable quantity of cerebrospinal fluid before gas is injected. In the experience of the author this may lead to lack of filling of the lateral ventricles, to unilateral filling with collapse of the unfilled ventricle, or to unequal filling. The better filled ventricle may then be found to be shifted to the opposite side, as judged from the position of the septum pellucidum. Unless this consideration is kept in mind one may be led to the erroneous diagnosis of a space-occupying lesion. The clue lies in the shape of the septum pellucidum. If it is found to be bowed, with the convexity toward the less well filled ventricle, the shift should be regarded as an artificial one and the diagnosis of a space-occupying mass may usually be discarded. In such an event, it may be possible by manipulation of the head to transfer sufficient gas to equalize the filling, and the ventricles may then be found to be normally situated (Case 1). If this manoeuvre is ineffective, it may be advisable to repeat the encephalogram to make the diagnosis clear. The following cases are examples of this variety of shift." @default.
• W1746599802 created "2016-06-24" @default.
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• W1746599802 date "1950-07-01" @default.
• W1746599802 modified "2023-09-25" @default.
• W1746599802 title "Non-Significant Ventricular Shift in Pneumoencephalograms" @default.
• W1746599802 doi "https://doi.org/10.1148/55.1.1" @default.
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