Document Detail


Lumboperitoneal shunting as a treatment for slit ventricle syndrome.
MedLine Citation:
PMID:  12006752     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Slit ventricle syndrome (SVS) has been described in hydrocephalus patients who continue to have shunt malfunction-like symptoms in the presence of a functioning shunt system and small ventricles on imaging studies. These symptoms usually present years after shunt placement or revision and can consist of headache, nausea and vomiting, lethargy and decreased cognitive skills. Treatments offered range from observation, medical therapy (migraine treatment) and shunt revision to subtemporal decompression or cranial vault expansion. We describe a subset of patients with SVS who were symptomatic with high intracranial pressure (ICP) as measured by sedated lumbar puncture and whose symptoms completely resolved after lumboperitoneal shunt (LPS) placement. METHODS: Seven patients with a diagnosis of SVS underwent lumboperitoneal shunting. The age at shunting ranged from 3 to 18 years. Most had undergone recent ventriculoperitoneal shunt (VPS) revisions for presentation of shunt malfunction-like symptoms. Despite this, all remained symptomatic and underwent a sedated lumbar puncture to measure opening pressure (OP). All had high OP in spite of a functional VPS and underwent LPS placement. RESULTS: All 7 patients had a prolonged period of overdrainage symptoms after lumboperitoneal shunting that resolved completely over several weeks. The initial etiology of hydrocephalus was reported to include trauma, aqueductal stenosis and intraventricular hemorrhage of prematurity. Two patients required revision of their LPS, after which their symptoms again resolved. CONCLUSION: In a certain subset of patients with SVS who are symptomatic from increased ICP, placement of an LPS is an effective treatment option. It appears that this subgroup of patients previously treated with ventriculoperitoneal shunting behave in a fashion similar to pseudotumor cerebri patients and respond well to lumboperitoneal shunting.
Authors:
Hoang Le; Bakhtiar Yamini; David M Frim
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  36     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-13     Completed Date:  2002-06-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  178-82     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Affiliation:
Section of Pediatric Neurosurgery, The University of Chicago Children's Hospital, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cerebrospinal Fluid Shunts / methods*
Child
Child, Preschool
Equipment Failure
Female
Follow-Up Studies
Humans
Hydrocephalus / surgery
Lumbosacral Region
Male
Peritoneal Cavity
Pseudotumor Cerebri / surgery*
Syndrome
Ventriculoperitoneal Shunt / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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