Ventricular sizes on computerized tomographic (CT) scans were compared in seven patients with Huntington disease, 20 patients with cerebral atrophy, and 20 normal controls. The bicaudate index--the ratio of the width of both lateral ventricles at the level of the heads of the caudate nuclei to the distance between the outer tables of the skull at the same level--significantly discriminated among the three groups. The bicaudate indices were: Huntington disease 0.209 +/- 0.007, cerebral atrophy 0.121 +/- 0.006, and controls 0.092 +/- 0.003.

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The clinical course of acute otitis media is usually short, and the process terminates because of the host's immune system, the infection-resistant properties of the mucosal linings, and the susceptibility of the major organisms (beta-hemolytic streptococcus or pneumococcus) to penicillin. However, a small proportion (1% to 5%) of untreated or inadequately treated patients may experience complications. Prior to the development of an intracranial complication of otomastoiditis, warning symptoms or signs may be evident; these include severe earache, severe headache, vertigo, chills and fever, and meningeal symptoms and signs. Increasing headache, particularly temporoparietal headache near the affected ear, often indicates an impending intracranial complication. This symptom, often the only indication of an epidural abscess, demands prompt investigation and medical and surgical intervention. In our experience, computed tomography (CT) permits accurate diagnosis of acute coalescent or latent (masked) mastoiditis and its associated complications. However, magnetic resonance imaging (MRI) remains the study of choice to evaluate otogenic intracranial complications. This article demonstrates the important role of MRI in diagnosing various stages of acute otomastoiditis and its associated complications.