Objectives:The occurrence of obstructive hydrocephalus (ObH) as sequelae of deep midline brain tumors (third and lateral ventricles, thalamic, pineal region, brainstem, and fourth ventricle) can be estimated up to 90% of cases. We believe that the mamillopontine distance (MPD) – the distance between the lower surface of the mammillary body and the upper surface of the pons in the sagittal images – can be a sufficiently reliable alternative to the Evans’ index (EI) for the diagnosis of ObH.Patients and Methods:The results of mamillopontine distance (MPD), Evans’ index (EI), and angle of corpus callosum (ACC) measurement of 43 patients with non-communicative hydrocephalus were analyzed compared with results of 30 people without brain pathology.Results:Findings revealed that MPD is a strong and reliable alternative to the EI. MPD showed high specificity and sensitivity in the diagnosis of occlusive hydrocephalus. Moreover, from those findings, we have proposed classification of the degree of hydrocephalus severity, depending on the MPD.Conclusion:MPD one of the more accurate and powerful method for defining presence of hydrocephalus in-patient even in early stage of occlusion. It has high specificity and sensitivity and capable classify hydrocephalus into grades according to severity.

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