Vol 69, No 2 (2010)
Original article
Submitted: 2012-02-06
Published online: 2010-05-27
Radiological anatomy of the ambient cistern in children
T. Skadorwa, M. Eibl, E. Zygańska, B. Ciszek
Folia Morphol 2010;69(2):78-83.
Vol 69, No 2 (2010)
ORIGINAL ARTICLES
Submitted: 2012-02-06
Published online: 2010-05-27
Abstract
Ambient cistern (AC) is a thin extension of the subarachnoid space surrounding
the brainstem at the level of the mesencephalon and pons. Despite various
definitions, it constitutes an important landmark in clinical assessment of intracranial
volume reserve. Although it is indisputably useful, there exists no
defined standard for radiological examination for the dimensions and ranges
in specific age groups. This paper aims to describe the ambient cistern anatomically
and give the ranges of dimensions for proper radiological interpretation.
The study was performed on 160 axial computed tomography (CT) examinations
of Polish children of both sexes, aged 1-18 years, admitted to the
hospital because of mild brain concussion. Pictures were made using a Siemens
8-row CT scanner, without contrast administration. We estimated distances
at the level of the pons and midbrain, based on axial cross-sections,
according to standard radiological protocol. The parameters included the width
of the AC in its anterior and posterior part, the width of the tentorial notch,
and the distance from the pons and sella. All measurements were analyzed
statistically with StatSoft Statistica 8.0 software. The average width of the AC
differs between age groups. It is greatest at 1-3 years (2.8 ± 0.6 mm) and
lowest at 4-10 years (2.4 ± 0.6 mm). AC is more likely to be greater in its
anterior part in boys. The distance from the sella to the pons is greatest in 1-3-year-old girls (6.9 ± 1.3 mm), and the tentorial notch is widest in the 15-18-year-old group (24.6 ± 2.4 mm). Dimensions of the AC correlate with intracranial
reserve volume. This is particularly visible in the youngest children. Thin
and narrow AC is not always a sign of raised intracranial pressure. It may be
specific for the child’s age.
(Folia Morphol 2010; 69, 2: 78-83)
Abstract
Ambient cistern (AC) is a thin extension of the subarachnoid space surrounding
the brainstem at the level of the mesencephalon and pons. Despite various
definitions, it constitutes an important landmark in clinical assessment of intracranial
volume reserve. Although it is indisputably useful, there exists no
defined standard for radiological examination for the dimensions and ranges
in specific age groups. This paper aims to describe the ambient cistern anatomically
and give the ranges of dimensions for proper radiological interpretation.
The study was performed on 160 axial computed tomography (CT) examinations
of Polish children of both sexes, aged 1-18 years, admitted to the
hospital because of mild brain concussion. Pictures were made using a Siemens
8-row CT scanner, without contrast administration. We estimated distances
at the level of the pons and midbrain, based on axial cross-sections,
according to standard radiological protocol. The parameters included the width
of the AC in its anterior and posterior part, the width of the tentorial notch,
and the distance from the pons and sella. All measurements were analyzed
statistically with StatSoft Statistica 8.0 software. The average width of the AC
differs between age groups. It is greatest at 1-3 years (2.8 ± 0.6 mm) and
lowest at 4-10 years (2.4 ± 0.6 mm). AC is more likely to be greater in its
anterior part in boys. The distance from the sella to the pons is greatest in 1-3-year-old girls (6.9 ± 1.3 mm), and the tentorial notch is widest in the 15-18-year-old group (24.6 ± 2.4 mm). Dimensions of the AC correlate with intracranial
reserve volume. This is particularly visible in the youngest children. Thin
and narrow AC is not always a sign of raised intracranial pressure. It may be
specific for the child’s age.
(Folia Morphol 2010; 69, 2: 78-83)
Keywords
ambient cistern; radiological anatomy
Title
Radiological anatomy of the ambient cistern in children
Journal
Folia Morphologica
Issue
Vol 69, No 2 (2010)
Article type
Original article
Pages
78-83
Published online
2010-05-27
Page views
553
Article views/downloads
1668
Bibliographic record
Folia Morphol 2010;69(2):78-83.
Keywords
ambient cistern
radiological anatomy
Authors
T. Skadorwa
M. Eibl
E. Zygańska
B. Ciszek