Predicting slitlike ventricles in children on the basis of baseline characteristics at the time of shunt insertion

Update item information
Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Kestle, John R. W.
Other Author Kan, Peter; Walker, Marion L.; Drake, James M.
Title Predicting slitlike ventricles in children on the basis of baseline characteristics at the time of shunt insertion
Date 2007
Description Object. Slit ventricle syndrome (SVS) is a delayed complication of shunt insertion and occurs only in children with slitlike ventricles after shunt placement. Although SVS appears to be related to early shunt placement, its predisposing factors are largely unknown. Methods. Baseline data in 737 children who had received shunts were obtained from the databases of two previous clinical trials. Ventricular size before shunt placement and at the last routine follow up was measured using the frontooccipital horn ratio (FOHR). Ventricles with an FOHR less than or equal to 0.2 at follow up were classified as slitlike ventricles. A univariate analysis was performed on data obtained in children with more than 1 year of clinical and radiographic follow up to identify risk factors for developing slitlike ventricles. These results were entered into a multivariate analysis to identify independent predictors of slitlike ventricles. Two hundred forty-four children had more than 1 year of clinical and radiographic follow-up data. The 23 patients (9.4%) who developed slitlike ventricles had shunts inserted at a younger age (42 compared with 134 days, p = 0.09) and were more likely to have developed hydrocephalus secondary to infection (37.5%), head injury (25.0%), or aqueductal stenosis (22.2%). Slitlike ventricles were seen in 10.8% of patients with differential-pressure valves, 10.5% of patients with Delta valves, and 3.6% of patients with Orbis-Sigma valves (p = 0.007). Regression analysis supported the role of the valve type in developing slitlike ventricles. Conclusions. Age at shunt insertion and valve type appear to be the modifiable risk factors for developing slitlike ventricles. If the authors of subsequent studies can further validate these conclusions, slow-draining valves and delayed shunt insertion might be used to decrease the incidence of slitlike ventricles and SVS.
Type Text
Publisher American Association of Neurological Surgeons (AANS)
Volume 106
Issue 5 Suppl
First Page 347
Last Page 349
Subject Slitlike ventricles; Slit ventricle syndrome; Shunt insertion; Predictive factor; Ventriculoperitoneal shunt; Pediatric neurosurgery
Subject LCSH Brain -- Ventricles -- Abnormalities; Hydrocephalus in children; Pediatric neurology; Cerebrospinal fluid shunts
Language eng
Bibliographic Citation Kan, P., Walker, M. L., Drake, J. M., & Kestle, J. R. W. (2007). Predicting slitlike ventricles in children on the basis of baseline characteristics at the time of shunt insertion. Journal of Neurosurgery, 106(5 Suppl), 347-9.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 68,036 bytes
Identifier ir-main,13210
ARK ark:/87278/s6xs6d3d
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 707502
Reference URL https://collections.lib.utah.edu/ark:/87278/s6xs6d3d