Distal slit valve and clinically relevant CSF overdrainage in children with hydrocephalus

Distal slit valve (DSV) is a system designed for the treatment of hydrocephalus. It has been assumed that, by dispensing with an anti-siphon (AS) mechanism, the DSV induces a set of clinical symptoms associated with fluid overdrainage in patients. Nonetheless, there is no published evidence to suppo...

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Bibliographic Details
Published in:Child's nervous system 2002-02, Vol.18 (1-2), p.15-18
Main Authors: VIRELLA, Anthony A, GALARZA, Marcelo, MASTERMAN-SMITH, Michael, LEMUS, Rafael, LAZAREFF, Jorge A
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Cerebral Ventricles - pathology
Cerebrospinal Fluid Pressure
Cerebrospinal fluid. Meninges. Spinal cord
Child
Child, Preschool
Equipment Design
Headache - diagnosis
Headache - etiology
Headache - surgery
Humans
Hydrocephalus - physiopathology
Hydrocephalus - therapy
Infant
Infant, Newborn
Magnetic Resonance Imaging
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Reoperation
Retrospective Studies
Ventriculoperitoneal Shunt - adverse effects
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Summary:Distal slit valve (DSV) is a system designed for the treatment of hydrocephalus. It has been assumed that, by dispensing with an anti-siphon (AS) mechanism, the DSV induces a set of clinical symptoms associated with fluid overdrainage in patients. Nonetheless, there is no published evidence to support this assumption. Thus, to determine whether such an association is valid, we reviewed the records of 101 hydrocephalic patients (150 procedures) who had DSVs placed at our institution. The records of 40 hydrocephalic patients (69 procedures) in whom anti-siphon devices (AS) were placed were also reviewed. One DSV patient presented with slit ventricle syndrome (SVS) and low intracranial pressure (ICP). No DSV patients had postoperative subdural collection. One AS patient had a postoperative subdural collection. Thirty-one DSV patients (31%) each required one revision, and 8 (8%) required more than one revision. Twelve AS patients (30%) required one revision and 8 AS patients (20%) required more than one revision. No significant differences were found between the DSV and AS groups in number of revisions, infections or overdrainage. We did not find a direct correlation between clinically relevant CSF overdrainage and DSV.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-001-0544-1