Abstract
A total of 32 patients with overdrainage of CSF, fulfilling the radiological and clinical criteria for collapsed ventricles (“slit ventricles”), were classified into acute, subacute and chronic forms. The basis of classification into these categories was neurologic symptomatology. The majority (29 patients) originally had a ventriculoatrial shunt and 3 had ventriculoperitoneal shunts. Operative correction was performed in 23 patients (insertion of a high pressure valve in 18 and an antisiphon device in 5). Of these, 5 had acute, 10 subacute, and 6 chronic symptoms. Two patients without symptoms were operated on also. During the follow-up period, which varied from 2 to 11 months, no patient has shown recurrence of the original symptoms of the slit ventricle syndrome; two patients developed subacute signs and an antisiphon device was inserted in addition to the high-resistance valve. On the basis of this series, it is concluded that the slit ventricle syndrome can also develop in patients with an atrioventricular shunt and can be treated by preventing further overdrainage of CSF. Though the results are acceptable by present methods, the need for a servo-regulated shunt persists. The surgical correction should preferably be performed before the acute phase. A flowchart is presented for management of a child with suspected slit ventricles.
Similar content being viewed by others
References
Bradley KC (1970) Cerebrospinal fluid pressure. J Neurol Neurosurg Psychiatry 33:387–397
Collman H, Mauersberga W, Mohr G (1979) Clinical observations and CSF absorption studies in the slit ventricle syndrome. Lecture, Neurochirurgische Jahrestagung, Essen (FRG) 1979
Epstein FJ, Fleischer AS, Hochwald GM, Ransohoff I (1974) Subtemporal craniectomy for recurrent shunt obstructions secondary to small ventricles. J Neurosurg 41:29–31
Faulhauer K, Schmitz P (1978) Over drainage phenomena in shunt treated hydrocephalus. Acta Neurochir 45:89–101
Fox JL, McCullough DC, Green RC (1973) Effect of CSF shunts on intracranial pressure and CSF dynamics. II. A new technique of pressure measurement, result and concept. J Neurol Neurosurg Psychiatry 36:302–312
Gruber R (1983) Should “normalization” of the ventricles be the goal of hydrocephalus therapy? Z Kinderchir [Suppl 2] 38:80–83
Hakim S (1973) Hydraulic and mechanical miss-matching of valve shunts used in the treatment of hydrocephalus: the need for a servo-valve shunt. Dev Med Child Neurol 15:646–653
Hirayama H (1982) Slit ventricle — a reluctant goal of ventriculoperitoneal shunt. Monogr Neural Sci 8:108–111
Hoffman HJ (1982) Technical problems in shunts. Monogr Neural Sci 8:158–169
Holness RO, Hoffman HJ, Hendrich EB (1979) Subtemporal decompression for the slit ventricle syndrome after shunt in hydrocephalic children. Child's Brain 5:137–144
Hyde-Brown MD, Rekate HL, Nulsen FE (1981) Re-expansion of previously collapsed ventricles: the slit ventricle syndrome. J Neurosurg 56:536–539
Kiekens R, Mortier W, Pothman R, Bock WJ, Seibert H (1982) The slit ventricle syndrome after shunting in hydrocephalic children. Neuropaediatrie 13:190–194
Loman J (1934) Components of cerebrospinal fluid pressure affected by changes in pressure. Arch Neurol Psychiatry 31:679–681
McCullough DC, Fox JZ (1974) Negative intracranial pressure hydrocephalus in adults with shunts and its relationship to prediction and subdural teratoma. J Neurosurg 40:372–375
McCullough DC, Wells M (1983) Complications with antisiphon device in hydrocephalus with ventriculoperitoneal shunts. Concepts Paediatr Surg 2:63–75
Naidich TP, Epstein F, Lin JP, Kricheff II, Hochwald GM (1976) Evaluation of paediatric hydrocephalus by computed tomography. Radiology 119:337–345
Nulsen FE, Rekate HL (1979) Results of treatment for hydrocephalus as a guide to future management. In: Section of pediatric neurosurgery of the American Association of Neurological Surgeons (ed) Pediatric neurosurgery. Grune & Stratton, New York, pp 229–241
Nulsen FE, Spitz ED (1952) Treatment of hydrocephalus by direct shunt from ventricle to jugular vein. Surg Forum 2:399–403
Portnoy HD, Schulte RD, Fox JL, Croissant PD, Tripp L (1973) Antisiphon and reversible valves for shunting preventing post-shunt subdural haematomas. J Neurosurg 38:729–738
Salmon JH (1978) The collapsed ventricle: management and prevention. Surg Neurol 9:349–352
Shucart WA, Conolly R (1975) Experimental negative intraventricular pressures. J Surg Res 19:43–46
Yamada H, Masataka T, Mashiro N (1975) Effect of respiratory movement on cerebrospinal fluid dynamics in hydrocephalic infants with shunt. J Neurosurg 42:194–200
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Serlo, W., Heikkinen, E., Saukkonen, AL. et al. Classification and management of the slit ventricle syndrome. Child's Nerv Syst 1, 194–199 (1985). https://doi.org/10.1007/BF00270761
Issue Date:
DOI: https://doi.org/10.1007/BF00270761