From the Research
Slit ventricle syndrome should be managed with surgical intervention, including shunt revision with the installation of an anti-siphon device or programmable valve to prevent overdrainage, as this approach has been shown to improve outcomes in patients with this condition, with a complete resolution rate of 55% and improvement rate of 32% 1. The primary symptoms of slit ventricle syndrome include headaches, nausea, vomiting, and altered mental status that often worsen when the patient is upright.
- The condition typically develops in patients who have had long-term shunting for hydrocephalus.
- The underlying mechanism involves the brain becoming dependent on the shunt, with reduced compliance and inability to accommodate normal CSF pressure fluctuations.
- The ventricles collapse around the catheter when the patient is upright due to siphoning effect, causing intermittent shunt obstruction.
- Early recognition is important as untreated slit ventricle syndrome can lead to chronic headaches, cognitive impairment, and reduced quality of life.
- Management typically begins with conservative measures such as hydration and lying flat to alleviate symptoms, but surgical intervention may be necessary in severe cases.
- The use of programmable valves, such as ProGav Mietke or Medos Codman, has been shown to be effective in managing slit ventricle syndrome, with comparable outcomes between the two valves 1.
- In selected cases, a programmable antisiphon system, such as ProSa, may be used to improve outcomes.
- Pediatric age, uncomplicated shunt courses, and short SVS histories have been identified as favorable indicators for improved outcomes in patients with slit ventricle syndrome 1.