The truth and coherence behind the concept of overdrainage of cerebrospinal fluid in hydrocephalic patients

Introduction Overdrainage, siphoning, and slit-ventricle syndrome are well-documented complications of shunting in hydrocephalic patients. Despite the prevalence of these conditions, their mechanisms are still not fully understood. In this paper, the authors trace the concept of overdrainage and the...

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Bibliographic Details
Published in:Child's nervous system 2014-04, Vol.30 (4), p.599-606
Main Authors: Cheok, Stephanie, Chen, Jason, Lazareff, Jorge
Format: Article
Language:English
Subjects:
Cerebrospinal Fluid Shunts - adverse effects
Cerebrospinal Fluid Shunts - history
History, 20th Century
History, 21st Century
Humans
Hydrocephalus - surgery
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Original Paper
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative Complications - history
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Summary:Introduction Overdrainage, siphoning, and slit-ventricle syndrome are well-documented complications of shunting in hydrocephalic patients. Despite the prevalence of these conditions, their mechanisms are still not fully understood. In this paper, the authors trace the concept of overdrainage and the related phenomena of siphoning and slit-ventricle syndrome. Purpose To provide a historical overview of overdrainage and to reignite discussion of a topic that has been settled. Methods and results A medical literature search and review were performed via Google Scholar. Of 565 publications, 3 primary papers were identified and a timeline was developed demonstrating the convergence of the aforementioned concepts. From the primary papers, 25 relevant publications were selected and further analyzed searching for hypothesis, evidence, and conclusions. Conclusion Overdrainage, siphoning, and slit-ventricle syndrome are associated concepts that have converged into a pathophysiological theory where siphoning of CSF leads to overdrainage, which is then hypothesized to cause slit-ventricle syndrome in a small subset of patients. Our data suggests that while there have been numerous reports regarding overdrainage and its consequences, the evidence is not as robust as currently presumed and this subject requires prospective exploration.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-013-2327-x