Slit Ventricle as a Neurosurgical Emergency: Case Report and Review of Literature

Mencser, Zoltán; Kopniczky, Zsolt; Kis, Dávid; Barzó, Pál

doi:10.1016/j.wneu.2019.07.006

Cited by 7 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The so-called "dorsal midbrain syndrome" (conjugate vertical gaze palsy, parkinsonism, memory loss, fluctuation in the level of consciousness, hypothalamic dysfunction, hypersalivation, peripheral facial palsy and blepharospasm) has also been reported as a result of overdrainage, upward midbrain herniation and aqueduct obstruction [57]. Finally, symptoms and signs of sustained intracranial hypertension may appear (papilledema, altered consciousness, bradycardia or systemic hypertension) [29,34,58] with management of these states sometimes being a life-threatening emergency [59].…”

Section: Clinical Manifestations In Shunt Overdrainagementioning

confidence: 99%

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Ros

Iglesias

Linares

et al. 2021

JCM

View full text Add to dashboard Cite

Although shunt overdrainage is a well-known complication in hydrocephalus management, the problem has been underestimated. Current literature suggests that the topic requires more examination. An insight into this condition is limited by a lack of universally agreed-upon diagnostic criteria, heterogeneity of published series, the multitude of different management options and misunderstanding of relationships among pathophysiological mechanisms involved. We carried out a review of the literature on clinical, radiological, intracranial pressure (ICP), pathophysiological and treatment concepts to finally propose an integrative model. Active prophylaxis and management are proposed according to this model based on determination of pathophysiological mechanisms and predisposing factors behind each individual case. As pathophysiology is progressively multifactorial, prevention of siphoning with gravitational valves or antisiphon devices is mandatory to avoid or minimize further complications. Shunt optimization or transferal and neuroendoscopy may be recommended when ventricular collapse and cerebrospinal fluid isolation appear. Cranial expansion may be useful in congenital or acquired craniocerebral disproportion and shunting the subarachnoid space in communicating venous hydrocephalus and idiopathic intracranial hypertension.

show abstract

Section: Clinical Manifestations In Shunt Overdrainagementioning

confidence: 99%

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Ros

Iglesias

Linares

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…[ 3 ] Lumboperitoneal shunts can be used alone or in combination with the third ventriculostomy, or other treatment modalities, depending on the underlying pathology. [ 14 ] An interesting case report, referring that only bilateral shunting of the ventricular system was able to eliminate the symptoms permanently,[ 49 ] is recently reported.…”

Section: Discussionmentioning

confidence: 99%

“…In case that the treatment armamentarium that is available for SVS (e.g., shunt revision, cranial expansion, lumboperitoneal shunt) does not work,[ 47 48 49 ] there are studies which have described endoscopic procedures for the treatment of SVS. These include shunt replacement, shunt removal, and endoscopic third ventriculostomy (ETV), which are safe and effective treatment options.…”

Section: Discussionmentioning

confidence: 99%

Slit ventricle syndrome

2021

View full text Add to dashboard Cite

After the introduction of shunt treatment for the management of childhood hydrocephalus, a wide variety of complications related to this treatment modality have been recognized. The entity of slit ventricle syndrome (alternatively, symptomatic ventricular coaptation) is one of them, is frequently encountered in the pediatric population and its symptom complex resembles that of shunt failure. We conducted research on PubMed®, MEDLINE®, and Web of Science®, using the keywords: “slit ventricles,” “slit ventricle syndrome,” “SVS” and “ventricular coaptation.” The aim of our review was to trace the advances made through the past decades, concerning our knowledge about the clinical characteristics, pathophysiology, and treatment options of this entity. The discrepancy among researchers about the offending etiology and the optimum treatment algorithm of this entity, as well as the necessity of an updated concept regarding shunt over drainage is analyzed. The multiple treatment modalities proposed and pathophysiologic mechanisms implicated for the treatment of slit ventricle syndrome illustrate the complexity of this entity. Consequently, the issue requires more detailed evaluation. In this review, we comment on all the main facets related to shunt over drainage and the resultant slit ventricle syndrome.

show abstract

“…The variety of available treatments for SVS, as well as the complexity of the clinical case we have described, together point to the need for a profound comprehension of the clinical context when choosing the most appropriate management of SVS [8,12]. Isolated dilatation of the fourth ventricle is a rare complication of ventriculoperitoneal shunt surgery, with it being most frequent among pediatric patients and poorly characterized in adults [16,17].…”

Section: Casementioning

confidence: 99%

“…Treatment of proper SVS, with pathological compliance of the ventricular system, is more controversial. Proposed interventions are highly heterogeneous and include shunt revision/repositioning/substitution, third ventriculostomy, an increase in valve opening pressure, and decompressive surgery [ 8 , 12 ]. This is because appropriate treatment should be provided according to the underlying pathophysiological context, not the epiphenomenon of altered ventricular compliance.…”

mentioning

confidence: 99%

Rare Complications of CSF Diversion: Paradoxical Neuroimaging Findings in a Double, Chiasmic Case Report

Di Salle,

Migaleddu,

Canovetti

et al. 2024

Diagnostics

View full text Add to dashboard Cite

Two patients with CSF shunting systems exhibited symptoms of altered intracranial pressure. Initial neuroimaging led to misinterpretation, but integrating clinical history and follow-up imaging revealed the true diagnosis. In the first case, reduced ventricular size was mistaken for CSF overdrainage, while the actual problem was increased intracranial pressure, as seen in slit ventricle syndrome. In the second case, symptoms attributed to intracranial hypertension were due to CSF overdrainage causing tonsillar displacement and hydrocephalus. Adjusting the spinoperitoneal shunt pressure resolved symptoms and imaging abnormalities. These cases highlight the necessity of correlating clinical presentation with a deep understanding of CSF dynamics in shunt assessments.

show abstract

Slit Ventricle as a Neurosurgical Emergency: Case Report and Review of Literature

Cited by 7 publications

References 32 publications

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Slit ventricle syndrome

Rare Complications of CSF Diversion: Paradoxical Neuroimaging Findings in a Double, Chiasmic Case Report

Contact Info

Product

Resources

About