ArticleClinical neuroradiology2022
Midline Shift in Chronic Subdural Hematoma : Interrater Reliability of Different Measuring Methods and Implications for Standardized Rating in Embolization Trials.
Article in Clinical neuroradiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 6 citations in OpenAlex.
- Incidence and predictors of contralateral surgery after initial unilateral evacuation of bilateral chronic subdural hematomas: A population-based cohort study.Brain & spine · 2026Article
- Efficient automated quantification of midline shift in intracerebral hemorrhage using a binarized deep learning model on non-contrast head CT.Neuroradiology · 2026Article
- Brain Midline Approximation to Improve Symmetry Analysis of Brain CT Scans.Journal of imaging informatics in medicine · 2025Article
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13 authors at 5 institutions in 4 countries.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveEvaluation of chronic subdural hematoma (cSDH) treatment success relies on radiologic measures, in particular hematoma volume, width and midline shift (MLS). Nevertheless, there are no validated standards for MLS measurement in cSDH. Aim of this study was to identify the most reliable measurement location and technique for MLS.
methodsAdmission CT scans of 57 patients with unilateral cSDH were retrospectively analyzed. Axial slices were evaluated by 4 raters with MLS measurement in 4 locations, foramen of Monro (FM), thalamus (Th), mid-septum pellucidum (SP), maximum overall MLS (max) with 2 different techniques: displacement perpendicular to anatomical (ideal) midline (MLS-M), and displacement relative to the tabula interna in relation to the width of the intracranial space (MLS-T). Intraclass correlation coefficients (ICC) were calculated to assess interrater reliability and agreement of MLS‑M and MLS‑T measurement techniques. Measurements of cSDH volume and width were conducted for further data alignment.
resultsThe ICCs between readers were excellent (> 0.9) for all MLS‑M locations and for MLS-T_Th and ML-T_FM. The ICC was higher for MLS‑M than for MLS‑T in all locations. MLS-M_max showed the highest correlation coefficient of 0.78 with cSDH volume. Variance of MLS-M_max was explained in 64% of cases (adj. R squared) by cSDH volume based on a simple linear regression model. An increase of 10 ml cSDH volume resulted in an average increase of 0.8 mm MLS-M_max.
conclusionThe MLS measurement in cSDH patients should be standardized, and due to its high interrater reliability, the MLS‑M technique should be preferred.
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