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New York University Medical Center New York, NY 10016

The journal invites readers to submit short, well-focused questions about specific topics that trouble them in their practice. The questions should be typed double-spaced and must not be longer than one-half page. The author's name and address should be included, but these will not be published if so requested. Questions will be answered by consultants selected by the Editor. All questions are subject to editing and will be published as space permits. Answers supplied by radiologist consultants should not be considered inclusive of all approaches to a problem or exclusive of other methods of obtaining the same result. Consultants' recommendations on any specific radiologic procedure or course of conduct should be considered in light of the circumstances presented by an individual patient's situation.

Frontal horn asymmetry is a common occurrence without clear pathologic basis. Several correlates have been tested, including the patient's left- or right-handedness, age, and so-called functional weakness of the septum pellucidum. However, the mechanism that leads to this asymmetry still remains conjectural, and the range of acceptable asymmetry is unknown.

Asymmetry of the lateral ventricles and frontal horns may simulate unilateral hydrocephalus or the presence of an intraventricular cystic lesion. Therefore, it is important to rule out an intraventricular or periventricular structural or signal abnormality. Neuropathologic examination of the periventricular brain in cases of frontal horn asymmetry invariably shows normal brain parenchyma.

To put a number on this finding, we retrospectively reviewed the MR imaging findings of 76 consecutive patients, including 28 males and 48 females who ranged in age from 1 to 77 years (mean age, 38.5 years). The patients were reported to be healthy and had normal neurologic evaluations. We found that 46 patients had no demonstrable asymmetry between the frontal horns, whereas 30 patients had unambiguous asymmetry; 18 patients showed a smaller right frontal horn and 12, a smaller left frontal horn. Except for the asymmetry of the frontal horns, there was no evidence of other structural asymmetry, midline shift, abnormality involving the septum pellucidum, or presence of a mass lesion. Clinically, the most common symptom of this group was a headache. At more than 6 months follow-up, none of the patients returned for reimaging.

In summary, asymmetry of the frontal horns can be considered a normal variant as long as no discernible parenchymal or intraventricular abnormality is present.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cha, S. Articles by George, A. E. Search for Related Content PubMed Articles by Cha, S. Articles by George, A. E. Social Bookmarking                      What's this?