A comparative study of digital nerve and digital arterial repairs performed using running versus interrupted suture techniques in finger replantations.

BACKGROUND: The present study aimed to retrospectively analyze replantations and compared the success rates of different suturing techniques. METHODS: The data of 54 patients who underwent 82 finger replantations between January 2016 and April 2020 were retrospectively analyzed. Patients who underwent traumatic total finger amputations were included in the study. Arteries were repaired with two techniques, the simple running suture technique and the simple interrupted suture technique. Demographic patient data, comorbidities, operative data, post-operative care, the length of hospital stay, mechanism of injury, and site of injury were recorded. The groups were statistically analyzed. Functional outcomes were evaluated according to the Quick DASH score. RESULTS: A total 54 patients with a mean age of 32.5±18.4 (range 1-75) who underwent finger replantation were included in the study. The mean duration of follow-up was 30.9±16.1 months. The mechanism of injury was guillotine-style injury in 29 (35.4%) fingers, avulsion injury in 15 (18.3%) fingers, and crush injury in 38 (46.3%) fingers. Forty-six fingers were repaired using a simple running suture technique, and 36 fingers were repaired using a simple interrupted suture technique. There was no statistically significant difference in terms of failure between the suture techniques (p=0.569). Further, although there was no statistically significant difference in Quick DASH scores according to the type of trauma in the simple running suture technique group (p=0.109), a comparison could not be made within simple interrupted suture technique group because of the small sample size. There was no statistically significant difference in failure rates between cases with an ischemia duration of <6 h and those with ischemia duration of 6-12 h (p>0.05). No statistically significant difference was found between the groups according to age, body mass index, arterial hypertension, or diabetes mellitus (p>0.05). Statistically significant differences were found in univariate analysis according to surgery time per digit, smokers, or vein repair (p<0.05). In total, 65 (79.3%) out of 82 finger replantations were successful. A total of 17 out of 30 fingers that could not undergo venous repair survived because of treatment with medicinal leeches. CONCLUSION: Finger replantation is a difficult-to-perform surgical procedure requiring consideration of the surgical indications and the presence of an experienced surgical team. Regardless of the suture technique in finger amputations, performing venous anastomosis after arterial anastomosis is essential to restore circulation.

Do Techniques for Hill-Sachs Remplissage Matter in Terms of Functional and Radiological Outcomes?

BACKGROUND: Different techniques are used for the remplissage procedure, including the double-pulley and mattress suture techniques. Both techniques have shown good results; however, it is unclear if one technique is superior. HYPOTHESIS: The remplissage procedure using the double-pulley technique with 2 anchors would have superior functional and radiological outcomes compared with the mattress suture technique with a single anchor. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study included patients with anterior shoulder instability who were treated using arthroscopic Bankart repair combined with remplissage between 2012 and 2017. A structured questionnaire was used to gather information on the following metrics: Instability Severity Index Score, hyperlaxity, Sugaya index, presence of a Hill-Sachs defect, number of dislocations before surgery, sports participation, radiological measurement of the Hill-Sachs lesion, postoperative range of motion in both shoulders, Rowe score, Walch-Duplay score, American Shoulder and Elbow Surgeons score, and Filling Index Score of Remplissage grade according to magnetic resonance imaging scans at the last follow-up. RESULTS: There were 41 patients included with a mean age of 30 ± 7 years who underwent the Hill-Sachs remplissage procedure using the double-pulley technique with 2 anchors (n = 21; group DA) or the mattress suture technique with a single anchor (n = 20; group SA). At the final follow-up, there were no significant differences between the groups regarding the Instability Severity Index Score (P = .134), the Sugaya index (P = .538), sports participation (P = .41), the radiological measurement of the Hill-Sachs lesion (P = .803), or the Rowe score (P = .182). However, there were significant differences between the groups in the Walch-Duplay score (P = .012), American Shoulder and Elbow Surgeons score (P = .005), and Filling Index Score of Remplissage grade (P = .015), favoring group DA, as well as differences in external rotation in a neutral position (external rotation loss: 9° ± 3° [group SA] vs 12° ± 3° [group DA]; P = .003) and at 90° of abduction (external rotation loss: 8° ± 3° [group SA] vs 11° ± 3° [group DA]; P = .006), favoring group SA. CONCLUSION: In the remplissage procedure, the double-pulley technique provided better filling of the lesion and improvement in functional scores, but external rotation was limited compared with the mattress suture technique.

A comparative study on use of two versus three double-loaded suture anchors in arthroscopic Bankart repair.

OBJECTIVES: This study aims to compare clinical results of repair using two versus three double-loaded suture anchors in arthroscopic Bankart repair. PATIENTS AND METHODS: Between July 2012 and December 2017, a total of 40 patients (38 males, 2 females; mean age: 31.6±8.1; range: 17 to 47 years) who underwent Bankart arthroscopic surgery and were followed for minimum two years were retrospectively analyzed. Group 1 (n=17) underwent arthroscopic Bankart repair with two double-loaded suture anchors, while Group 2 (n=23) underwent repair with three double-loaded suture anchors. Clinical outcomes of the patients and recurrences were compared. RESULTS: At the final postoperative follow-up, a significant improvement was observed in the functional outcomes in all patients. No statistically significant difference was found (p>0.05) in the mean clinical scores of the Constant Shoulder Score between Group 1 (94.2±7.8) and Group 2 (95.4±4.1). There was no significant difference in the mean Rowe scores (Group 1: 95.6±4.6 vs. Group 2: 96.3±3.8, respectively) and external rotation loss (at neutral Group 1: 1.9° vs. Group 2: 2.2°, respectively). Three of our patients had recurrent dislocation during a major traumatic event (n=2 in Group 1 and n=1 in Group 2). CONCLUSION: Our study results suggest that stability is not correlated with the use of either two versus three double-loaded suture anchors in arthroscopic Bankart repairs.

Arthroscopic excision of intraarticular subperiosteal osteoid osteoma of talar neck: A case report.

Osteoid osteoma (OO) is a benign, small, and painful tumor typically seen in the subcortical shaft and metaphysis of the long bones of the lower limb. The occurrence of this type of tumor on the talar neck is rare and may cause limitation of range of motion of the ankle joint. In this article, a 17-year-old male patient had ankle pain and limitation of joint motion accompanied by synovitis. The OO in the intraarticular subperiosteal talar neck was successfully excised arthroscopically and the nidus was completely removed. The diagnosis was confirmed histopathologically in the postoperative period. In this case, we achieved a successful result with surgical treatment of benign bone tumor in the talus with intraarticular excision of the lesion arthroscopically.

What Are We Missing From Asymmetric Relationship Between the Retinal Nerve Fiber Layer Thickness Profiles and Sphenoid Sinus Volume?

PURPOSE/AIM OF THE STUDY: Detailed analysis of retinal structure such as the retinal nerve fiber layer can be performed by spectral-domain optical coherence tomography (OCT). There are no published studies concerning a relationship between retinal nerve fiber layer and human sphenoid sinus volumes. We investigated this relationship. MATERIAL AND METHODS: Spectral-domain OCT. The peripapillary retinal nerve fiber layer (RNFL) thickness and sphenoid sinus volume estimation of both sides of sex-matched patients were retrospectively analyzed. RESULTS: The mean RNFL thicknesses at the left side (91.8 µm) were significantly smaller than the right side (94.5 µm) (P = 0.040). However, the mean left sinus volume (44.5 cm) is larger than the right side, (34.5 mm) (P < 0.005). Left and right differences of both parameters are statistically significant (P < 0.05). CONCLUSION: There is a negative correlation between mean RNFL thicknesses and mean sinus volumes. To our knowledge, this article is the first report demonstrating the asymmetry relationship between RNFL and sphenoid sinus volumes.

The Effect of Neuroscientists on the Studies of Autonomic Nervous System Dysfunction Following Experimental Subarachnoid Hemorrhage.

OBJECTIVE: The autonomic nervous system dysfunctions following subarachnoid hemorrhage (SAH) are common in neurosurgical clinical practice. The aim of the study is to investigate the effect of Asian neuroscientists on the studies of autonomic nervous system dysfunction following experimental subarachnoid hemorrhage. METHODS: A systematic search was conducted using the MEDLINE and Web of Science databases for studies pertaining to SAH and autonomic nervous system dysfunction. The searched terms contained "experimental subarachnoid hemorrhage," "autonomic nervous system," and "Ganglion." RESULTS: There are many animal studies because the live human brain vessels cannot be used in investigations. The considerable efforts have been made to investigate the effect of SAH on the autonomic nervous system in laboratory animals. Seventy-four studies were published by various authors. Most of the articles came from Asian Countries 49 studies (66.2% of the total studies). The most preferred animals were rabbits (in 43 studies, 58.1% of the total studies). CONCLUSION: Asian neuroscientists published enormous contributions in SAH-related autonomic nervous system dysfunction. It was shown that there is a great interest of Asian neuroscientists for autonomic nervous system changes secondary to SAH.

Association between blood pressure, inflammation and spirometry parameters in chronic obstructive pulmonary disease.

BACKGROUND/AIMS: Many systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction. METHODS: We included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups. RESULTS: In COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV1%). Diastolic blood pressure was associated with pH and HCO3 levels. The mean night time, day time pulse pressures and 24- hour pulse per minute values were also associated with all the parameters except FEV1%. CONCLUSION: In this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.

Unilateral Isolated Hypoglossal Nerve Palsy Caused by Gunshot Injury.

Cranial nerve palsies after gunshot injury are not uncommon. However, in the literature, only 1 patient with isolated hypoglossal nerve paralysis caused by gunshot has been published. The authors describe a 34-year-old man suffering from unilateral isolated hypoglossal nerve palsy caused by gunshot injury as a second reported patient. The bullet entered maxillary sinus, and caused condylar fracture, then ended up C1-2 interspace. The bullet was surgically removed by a posterior approach. It is important to pay attention to hypoglossal nerve injury when confronted with a gunshot wound. The authors recommend early and sufficient surgical decompression.

Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI.

BACKGROUND: Contrast induced nephropathy (CIN) has been proven to be a clinical condition related to adverse cardiovascular outcomes. In recent studies, the monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with CIN in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). METHODS: Consecutive STEMI patients treated with primary PCI were prospectively recruited. Subjects were categorized into two groups; as patients who developed CIN (CIN+) and patients who did not develop CIN (CIN-) during hospitalization. CIN was defined as either a 25% increase in serum creatinine from baseline or 44.20 µmol/L increase in absolute value, within 72 h of intravenous contrast administration. RESULTS: A total number of 209 patients were included in the study. Thirty-two patients developed CIN (15.3%). In the CIN (+) patients, monocytes were higher [1.02 (0.83-1.39) vs. 0.69 (0.53-0.90) 109/L, p<0.01] and HDL cholesterol levels were lower [0.88 (0.78-1.01) vs. 0.98 (0.88-1.14) mmol/L, p<0.01]. In addition, MHR was significantly higher in the CIN (+) group [1.16 (0.89-2.16) vs. 0.72 (0.53-0.95) 109/mmol, p<0.01]. In multivariate logistic regression analysis, MHR, Mehran score, AGEF score and CV/eGFR were independently correlated with CIN. CONCLUSIONS: Higher MHR levels may predict CIN development after primary PCI in STEMI patients.

Inequality in leg length is important for the understanding of the pathophysiology of lumbar disc herniation.

OBJECTIVE: Inequality in leg length may lead to to abnormal transmission of load across the endplates and degeneration lumbar spine and the disc space. There has been no study focusing on lumbar disc herniation (LDH) and leg length discrepancy. This subject was investigated in this study. MATERIALS AND METHODS: Consecutive adult patients with leg length discrepancy and low back pain (LBP) admitted to our department were respectivelly studied. RESULTS: A total number of 39 subjects (31 women and eight men) with leg length discrepancy and LBP and 43 (25 females and 18 males) patients with LBP as a control group were tested. Occurrence of disc herniation is statistically different between patients with hip dysplasia and control groups (P < 0.05). CONCLUSION: The results of this study showed a statistically significant association between leg length discrepancy and occurrence of LDH. The changes of spine anatomy with leg length discrepancy in hip dysplastic patients are of importance in understanding the nature of LDH.

Catheter-directed ultrasound-accelerated thrombolysis may be life-saving in patients with massive pulmonary embolism after failed systemic thrombolysis.

The treatment options for high risk acute pulmonary embolism (PE) patients with failed systemic thrombolytic treatment (STT) is limited. The clinical use of catheter directed thrombolysis with the EkoSonic Endovascular System (EKOS) in this population has not been evaluated before. Catheter directed thrombolysis is an effective treatment modality for high risk PE patients with failed STT. Thirteen consecutive patients with failed STT were included in the study. EKOS catheters were placed and tissue plasminogen activator (t-PA) in combination with unfractionated heparin were given. Clinical and echocardiographic properties of the patients were collected before EKOS, at the end of EKOS and during the follow-up visit 6 months after discharge. The duration of EKOS treatment was 21.8 ± 3.8 h and the total dose of tPA was 31.2 ± 15.3 mg. One patient who presented with cardiac arrest died and the clinical status of the remaining subjects improved significantly. Any hemorrhagic complication was not observed. EKOS resulted in significant improvement of right ventricular functions and decrease of systolic pulmonary artery pressure. During a follow-up period of 6 months none of the patients died or suffered recurrent PE. In addition, echocardiographic parameters or right ventricular function significantly got better compared to in-hospital measurements. EKOS is an effective treatment modality for high risk PE patients with failed STT and can be applied with very low hemorrhagic complications.

Long-term outcomes of pericardiectomy for constrictive pericarditis.

BACKGROUND: Constrictive pericarditis is a rare and disabling disease that can result in chronic fibrous thickening of the pericardium. The purpose of this study was to evaluate the long-term outcomes following treatment of constrictive pericarditis by pericardiectomy. METHODS: Between September 1992 and May 2014, 47 patients who underwent pericardiectomy for constrictive pericarditis were retrospectively examined. Demographic, pre-, intra- and postoperative data and long-term outcomes were analyzed. RESULTS: Thirty of the patients were male, the mean age was 45.8 ± 16.7. Aetiology of constrictive pericarditis was tuberculosis in 22 (46.8 %) patients, idiopathic in 15 (31.9 %), malignancy in 3 (6.4 %), prior cardiac surgery in 2 (4.3 %), non-tuberculosis bacterial infections in 2 (4.3 %), radiotherapy in 1 (2.1 %), uraemia in 1 (2.1 %) and post-traumatic in 1 (2.1 %). The surgical approach was achieved via a median sternotomy in all patients except only 1 patient. The mean operative time was 156.4 ± 45.7 min. Improvement in functional status in 80 % of patients' at least one New York Heart Association (NYHA) functional class was observed. In-hospital mortality rate was 2.1 % (1 of 47 patients). The cause of death was pneumonia leading to progressive respiratory failure. The late mortality rate was 23.4 % (11 of 47 patients). The mean follow-up time was 61.2 ± 66 months. The actuarial survival rates were 91 %, 85 % and 81 % at 1, 5 and 10 years, respectively. Recurrence requiring a repeat pericardiectomy was developed in no patient during follow-up. CONCLUSION: Pericardiectomy is associated with high morbidity and mortality rates. Cases with neoplastic diseases, diminished cardiac output, cases in need of reoperation are expected to have high mortality rates and less chance of functional recovery.

The relationship between cardiotrophin-1 and troponin-i in coronary arterial bypass grafting on the beating heart: a prospective study.

OBJECTIVE: Cardiotrophin-1 (CT-1) is closely associated with many cardiovascular diseases, such as hypertension, myocardial infarction (MI), and heart failure, and exhibits a cardioprotective effect in ischemia-reperfusion injury. The aim of this study was to evaluate the relationship between CT-1 and Troponin-I (Tn-I) in off-pump coronary artery bypass (OPCAB) grafting on the beating heart. METHODS: Seventy-eight patients (mean age 60.8 ± 9.7 years, 79.5% male) undergoing elective OPCAB surgery were included in this study undertaken between July 1, 2012 and July 1, 2013 in the Department of Cardiology and Cardiac Surgery, University School of Medicine Hospital. Venous blood samples were collected 5 minutes before OPCAB surgery and 6 hours after surgery. Plasma CT-1 levels were measured using the ELISA method. RESULTS: Compared to the preoperative period, Tn-I and CT-1 values were higher in the postoperative period [0.255 ng/mL (0.030-0.430) versus 0.045 ng/mL (0.005-0.090), P < .001; and 33.7 pg/mL (15.8-98.5) versus 8.7 pg/mL (0.68-25.4), P < .001]. There was also an elevation in white blood cells, aspartate aminotransferase, creatine kinase (CK), and creatine kinase MB (CK-MB) values, as well as a decrease in hemoglobin values (P < .001). When a correlation analysis for postoperative CT-1 was performed, there was a significant positive correlation between postoperative CK, CK-MB, and Tn-I levels (r = 0.250, P < .027; r = 0.270, P = .017; and r = 0.241, P < .034). CONCLUSION: CT-1 was found to be associated with Tn-I, which is used to detect myocardial damage after OPCAB surgery. CT-1 may also be used to detect myocardial damage.

Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness.

CONTEXT: Little seems to be known about the sexual dysfunction (SD) in lumbar intervertebral disc herniation. AIMS: Investigation of sexual and sphincter dysfunction in patient with lumbar disc hernitions. SETTINGS AND DESIGN: A retrospective analysis. MATERIALS AND METHODS: Sexual and sphincter dysfunction in patients admitted with lumbar disc herniations between September 2012-March 2014. STATISTICAL ANALYSIS USED: Statistical analysis was performed using the Predictive Analytics SoftWare (PASW) Statistics 18.0 for Windows (Statistical Package for the Social Sciences, SPSS Inc., Chicago, Illinois). The statistical significance was set at P < 0.05. The Wilcoxon signed ranks test was used to evaluate the difference between patients. RESULTS: Four patients with sexual and sphincter dysfunction were found, including two women and two men, aged between 20 and 52 years. All of them admitted without low back pain. In addition, on neurological examination, reflex and motor deficit were not found. However, almost all patients had perianal sensory deficit and sexual and sphincter dysfunction. Magnetic resonance imaging (MRI) of three patients displayed a large extruded disc fragment at L5-S1 level on the left side. In fourth patient, there were not prominent disc herniations. There was not statistically significant difference between pre-operative and post-operative sexual function, anal-urethral sphincter function, and perianal sensation score. A syndrome in L5-S1 disc herniation with sexual and sphincter dysfunction without pain and muscle weakness was noted. We think that it is crucial for neurosurgeons to early realise that paralysis of the sphincter and sexual dysfunction are possible in patients with lumbar L5-S1 disc disease. CONCLUSION: A syndrome with perianal sensory deficit, paralysis of the sphincter, and sexual dysfunction may occur in patients with lumbar L5-S1 disc disease. The improvement of perianal sensory deficit after surgery was counteracted by a trend toward disturbed sexual function. Further researches are needed to explore the extent of this problem.

Long-term outcome of unreamed intramedullary nails in femur diaphyseal fractures.

BACKGROUND: We evaluated the results of patients with traumatic femur diaphyseal fracture who had undergone biologic fixation with unreamed intramedullary nailing. METHODS: Twenty-five adults with 29 traumatic femur diaphyseal fractures who had undergone unreamed intramedullary nailing at Uludag University School of Medicine, Department of Orthopedics and Traumatology were included in the study between January 1997 and December 2007. Gender, age, cause of injury, fracture type, operation length, time lapse till surgery, blood loss, fluoroscopy duration, early and late complications, time until union, and functional results were noted. Functional results were evaluated with Klemm-Börner and Thoresen systems and Short Form (SF)-36 health survey questions. RESULTS: The mean follow-up of the patients was 65.1 +/- 31.6 months (26-138). There was no statistically significant difference between operation length, blood loss and time until union of simple and complex fractures (p > 0.05). Furthermore, the SF-36 questionnaire revealed no statistically significant difference between pain scores (p > 0.05). CONCLUSION: Sparing of the endosteal and periosteal circulation, low infection and high union rates, and good functional outcomes of unreamed intramedullary nailing fixation make it the treatment of choice for simple and comminuted fractures of the femur shaft, especially for multi-trauma patients and patients with cardiopulmonary comorbidities.

Dislodgement of a sirolimus-eluting stent in the circumflex artery and its successful deployment with a small-balloon technique.

Coronary stent dislodgement or embolization before deployment is a rare but serious complication in interventional cardiology. A 60-year-old male presented with unstable angina five years after coronary artery bypass surgery. There was a stenosis (70%) in the obtuse marginal branch of the circumflex artery. During percutaneous coronary intervention, a sirolimus-eluting stent was stripped from its balloon mainly because of significant proximal angulation and incarcerated within the proximal circumflex artery. A smaller balloon dilatation catheter was advanced and pushed through the inside of the slipped stent. Using this technique, the stent could be advanced into the lesion and was successfully deployed. To our knowledge, this is the first case report on sirolimus-eluting stent dislodgement.

A rare combination of left main coronary artery fistula to main pulmonary artery with severe left main coronary artery disease in a 69-year-old man.

A 69-year-old man was referred to our hospital with a diagnosis of non-ST elevation myocardial infarction. A selective left coronary angiography revealed a fistula connecting the left main coronary artery with the pulmonary artery in addition to severe left main coronary artery disease. The patient subsequently underwent ligation of fistulae and coronary bypass grafting. The combination of a fistula and severe artery disease seen in this patient is unusual because fistulas originating from the left main coronary artery drain into the pulmonary artery in patients with severe left main coronary artery disease.

Aortic distensibility and coronary artery bypass graft patency.

BACKGROUND: Aortic distensibility is an elasticity index of the aorta, and reflects aortic stiffness. Coronary artery disease has been found to be substantially associated with increased aortic stiffness. In this study we aimed to retrospectively analyze the association of angiographically determined aortic distensibility with the patency rates of coronary bypass grafts METHODS: The study was conducted in the Cardiology department of the Applied Research Centre for Health of Uludag University. The coronary angiograms of 53 consecutive coronary bypass patients were analysed retrospectively. Aortic distensibility was calculated using the formula: 2 x (change in aortic diameter)/(diastolic aortic diameter) x (change in aortic pressure). The number of stenosed and patent bypass grafts and the patient characteristics like age, risk factors were noted. RESULTS: There were 44 male (83%) and 9 female (17%) cases. Eighteen cases had only one saphenous vein grafting. The number of cases with two, three and four saphenous grafting were 18, 11 and 1; respectively. In the control angiograms the number of cases with one, two, three and four saphenous vein graft obstruction were 15 (31.3%), 7 (14.6%), 1 (2.1%) and 1 (2.1%) respectively. The aortic distensibility did not differ in cases with and without saphenous graft occlusion (p > 0.05). Also left internal mammary artery (LIMA) graft patency was not related to the distensibility of the aorta (p > 0.05). We also evaluated the data for cut-off values of 50 and 70 mmHg of pulse pressure and did not see any significant difference between the groups in terms of saphenous or LIMA grafts. CONCLUSION: In this study we failed to show association of angiographically determined aortic distensibility with coronary bypass graft patency in consecutive 53 patients with coronary artery bypass graft surgery (CABG).

Cerebral lateral ventricular asymmetry on CT: how much asymmetry is representing pathology?

PURPOSE: The purpose of this study was to evaluate the association of asymmetric lateral ventricle (ALV) with clinical and structural pathologies and assess its clinical importance. MATERIALS AND METHODS: We analyzed 170 consecutive ALV cases on computed tomography (CT) and 170 control group patients with normal head CT. Patients who had apparent etiologic causes for ALV were excluded. The differential diagnosis of ALV and unilateral hydrocephalus (UH) was made by using three different ventricle-brain ratios (VBRs). The measurements of the ALV were made at the frontal horn level. Patients with asymmetry were divided into three subgroups including mild, moderate and severe groups to eloborate the grade of the ventricular asymmetry. Additional CT findings including septal deviation, diffuse enlargement, atrophy and the densities of constant sites were also recorded systematically for each patient. Clinical and handedness data were collected and analyzed. RESULTS: The prevalence of ALV in the study population was 6.1%. Headache was the most common reason for head CT examination and was significantly more common in the asymmetry group (61.7% in group A, 42.9% in group B, P = 0.001). Transient ischemic attack, focal neurologic findings, vertigo, ataxia, visual and hearing disturbances were similar in both groups (P > 0.5). There was no difference in smoking and alcohol habits in both patient groups. Ten (5.8%) patients in group A and 16 (9.4%) patients in group B had neuropsychiatric disorders, which did not achieve statistical significance. In group A patients, the larger ventricle was more common in the left side than in the right (left = 70.0%, right = 30.0%). Group A consisted of 57.0% mild (grade 1, n = 97), 26.5% moderate (grade II, n = 45) and 16.5% severe (grade III, n = 28) patients. There was no significant correlation between handedness and ALV. The density of different brain sites was found close similar on both sides in ALV and control group (P > 0.5). Choroidal cystic or solid neoplasm or periventricular dysplasia was detected in six ALV patients in group A (3.5%), on their additional MR examinations. CONCLUSION: The physician should not overlook an ALV finding on unenhanced CT, particularly in cases with severe degree of asymmetry or diffuse ventricular enlargement, and search for possible accompanying disorders.