The Slit-Ventricle Syndrome After Shunting in Hydrocephalic Children

Kiekens, R; Mortier, W.; Pothmann, Raymund; Wj, Bock; Seibert, H

doi:10.1055/s-2008-1059621

Cited by 66 publications

(22 citation statements)

References 5 publications

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“…The incidence of SVS is said to be (Chapman 1990;Kiekens et al 1982). Patients with SVS may face life-threatening conditions, because the ventricles remain small or slit-like despite shunt malfunction.…”

Section: Discussionmentioning

confidence: 98%

“…SL V may lead to an acute shunt obstruction, but the obstruction in most cases with SL V is fortunately intermittent, because the increased intraventricular pressure which follows shunt obstruction dilates the ventricle and reopens the catheter (Salmon 1978). Slit ventricle syndrome (SVS) is therefore infrequent, but is a troublesome and life-threatening condition when it does occur (Epstein et al 1974;Gruber 1981;Holness et al 1979;Kiekens et al 1982;Nakada et al 1982;Salmon 1978). Low pressure shunts are used in many neurological centers for the treatment of pediatric hydrocephalus (Salmon 1978), and with the passage of time, ventricles may become slit-like.…”

Section: Introductionmentioning

confidence: 97%

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Importance of Anti-Siphon Devices in Shunt Therapy of Pediatric and Adolescent Hydrocephalus

Chiba¹,

Tokoro²,

Abé

1991

Hydrocephalus

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Summary. A Slit-like ventricle (SLV) is occasionally observed on computerized tomography (CT) scans in pediatric hydrocephalus. The incidence of SL V was investigated in 64 pediatric and adolescent patients with cerebrospinal fluid (CSF) shunts in relation to their activity of daily living (ADL) and to the presence or absence of an anti-siphon device (ASD). Patients were divided into three groups. Group A had full ADL and shunt systems with ASDs. Group B had full ADL and shunt systems without ASDs. Group C consisted of bedridden patients without ASDs in their shunt systems. All patients had hypertensive hydrocephalus. All but two had ventriculoperitoneal shunts. Medium pressure valves were inserted in all. The average follow-up period was 8.8 years. The incidence of SLY was 7.4% in group A, 53.1% in group B, 20% in group C, and 31.3% for all groups. Group A had a signicantly lower incidence of SLY than group B (X2 test, P < 0.001). One patient in group B developed slit ventricle syndrome. The CSF flow patterns through the shunt were examined using our thermosensitive technique. A rapid flow pattern was observed in most of group B. By contrast, this pattern was observed in only a few cases in group A. SLY appeared in only one out of four cases in group C despite the rapid CSF flow during positional changes.In conclusion, ASDs in the shunt system played an important role in reducing the incidence of SL V in the treatment of pediatric hydrocephalus, but some work on the use of ASDs for treating tall adolescent patients will still be necessary because of the large hydrostatic pressure involved.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 97%

Importance of Anti-Siphon Devices in Shunt Therapy of Pediatric and Adolescent Hydrocephalus

Chiba¹,

Tokoro²,

Abé

1991

Hydrocephalus

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“…Kiekens et al [7] attribute the symptoms of SVS to collapse of the ventricles and intermittent obstruction. They note that according to the law of La Place a col lapsed ventricle requires a higher pressure to promote dilatation than a ventricle of normal size and the symp toms are therefore due to this excessive pressure.…”

Section: Discussionmentioning

confidence: 99%

Slit-Ventricle Syndrome: Review of 15 Cases

McLaurin¹,

Olivi²

1987

Pediatr Neurosurg

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The slit-ventricle syndrome (SVS) has been the subject of diverse opinions and recommendations during the past 2 decades. In an effort to define the clinical features of SVS and to make recommendations concerning management we have reviewed 15 cases treated by a fairly uniform technique during the past 5 years. The syndrome consists of: (1) intermittent, but self-limiting episodes resembling shunt malfunction, usually lasting a few days, (2) nonfilling of the pumping device after compression, and (3) a slit-like ventricular system on CT scan. In all but 2 patients the initial shunt was performed in infancy. The mean interval from the initial shunt to treatment of SVS was 6 years. The age range at onset of SVS varied from 2 to 17 years with a mean of 7 years. All patients in this series were relieved of symptoms by placement of an antisiphon device and, in most patients, upgrading the valve resistance. Analysis of this series has led to the following conclusions: (1) SVS is a characteristic clinical entity, usually distinguishable from persistent shunt malfunction and from low-pressure headache, (2) the pathogenesis is intermittent obstruction of the ventricular catheter, (3) there is no good evidence that changes of brain compliance or La Place principles apply, and (4) placement of antisiphon device and upgrading valve resistance are effective treatments.

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“…Overdrainage of CSF has been reported in 5% to 55% of shunted patients [1,2]. Main clinical symptoms of slit ventricle are: headache, nausea, vomiting, and disturbances of consciousness, hemiparesis, and epileptic seizures [1]. Patients with Slit Ventricle have increased risk for further shunt complications.…”

Section: Introductionmentioning

confidence: 99%

“…The major groups of complications are obstructions, mechanical failure of the shunt, infections and overdrainage of cerebrospinal fluid. Overdrainage of CSF has been reported in 5% to 55% of shunted patients [1,2]. Main clinical symptoms of slit ventricle are: headache, nausea, vomiting, and disturbances of consciousness, hemiparesis, and epileptic seizures [1].…”

Section: Introductionmentioning

confidence: 99%