Short-term dexamethasone treatment for symptomatic slit ventricle syndrome

Fattal‐Valevski, Aviva; Beni‐Adani, Liana; Constantini, Shlomi

doi:10.1007/s00381-004-1132-y

Cited by 28 publications

(28 citation statements)

References 21 publications

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“…The effect is through specific binding to the mineralocorticoid receptor (NR3C2; nuclear receptor subfamily 3 group C member 2) on choroid plexus epithelial cells, with subsequent regulation of several functions [ 89 ]. In 13 shunted hydrocephalic children with symptomatic slit ventricle syndrome, dexamethasone was associated with temporary relief of symptoms, although 9/13 required subsequent surgical intervention [ 90 ]. In the context of hydrocephalus, corticosteroids have also been used as a possible way to reduce the fibrosis in the subarachnoid compartment (see below).…”

Section: Resultsmentioning

confidence: 99%

Nonsurgical therapy for hydrocephalus: a comprehensive and critical review

Bigio

Curzio

2015

Fluids Barriers CNS

102

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Pharmacological interventions have been tested experimentally and clinically to prevent hydrocephalus and avoid the need for shunting beginning in the 1950s. Clinical trials of varied quality have not demonstrated lasting and convincing protective effects through manipulation of cerebrospinal fluid production, diuresis, blood clot fibrinolysis, or manipulation of fibrosis in the subarachnoid compartment, although there remains some promise in the latter areas. Acetazolamide bolus seems to be useful for predicting shunt response in adults with hydrocephalus. Neuroprotection in the situation of established hydrocephalus has been tested experimentally beginning more recently. Therapies designed to modify blood flow or pulsation, reduce inflammation, reduce oxidative damage, or protect neurons are so far of limited success; more experimental work is needed in these areas. As has been recommended for preclinical studies in stroke and brain trauma, stringent conditions should be met for preclinical studies in hydrocephalus.Electronic supplementary materialThe online version of this article (doi:10.1186/s12987-016-0025-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Nonsurgical therapy for hydrocephalus: a comprehensive and critical review

Bigio

Curzio

2015

Fluids Barriers CNS

102

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“…Trapping of the fourth ventricle may occur in the presence of membranes blocking fourth ventricle outlets due to post-infective or posthemorrhagic inflammatory processes or chemical or radiation-induced ventriculitis [36]. In communicating hydrocephalus, when the whole ventricular system is collapsed, CSF may become isolated in the subarachnoid space (with raised ICP in this compartment) and a "shunt pseudotumor" develops [25,83].…”

Section: Ventricular Collapse and Csf Isolationmentioning

confidence: 99%

“…Predisposing factors for ventricular collapse and CSF isolation include shunt implantation during the first months of life [36,68,83], PHH of the newborn or premature [38,60,83] or neonatal meningitis [60,83], valves functioning well for several years [68,84] and lowpressure opening valves [36,84,85]. On the other hand, this phenomenon is unlikely to occur in patients with severe brain atrophy (i.e., cerebral palsy) [36] and in patients with myelomeningocele [38].…”

Section: Ventricular Collapse and Csf Isolationmentioning

confidence: 99%

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Ros

Iglesias

Linares

et al. 2021

JCM

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Although shunt overdrainage is a well-known complication in hydrocephalus management, the problem has been underestimated. Current literature suggests that the topic requires more examination. An insight into this condition is limited by a lack of universally agreed-upon diagnostic criteria, heterogeneity of published series, the multitude of different management options and misunderstanding of relationships among pathophysiological mechanisms involved. We carried out a review of the literature on clinical, radiological, intracranial pressure (ICP), pathophysiological and treatment concepts to finally propose an integrative model. Active prophylaxis and management are proposed according to this model based on determination of pathophysiological mechanisms and predisposing factors behind each individual case. As pathophysiology is progressively multifactorial, prevention of siphoning with gravitational valves or antisiphon devices is mandatory to avoid or minimize further complications. Shunt optimization or transferal and neuroendoscopy may be recommended when ventricular collapse and cerebrospinal fluid isolation appear. Cranial expansion may be useful in congenital or acquired craniocerebral disproportion and shunting the subarachnoid space in communicating venous hydrocephalus and idiopathic intracranial hypertension.

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“…Conservative management of SVS symptoms via excessive intravenous hydration and reclined head position was demonstrated to be successful in the early stages. Short-term steroids have been reported to be useful in transiently improving symptomatic complaints and delaying the need for surgery [23,24].…”

Section: Discussionmentioning

confidence: 99%

Slit ventricle syndrome: clinical and diagnostic pitfalls

Zapolska¹,

Gościk²,

Matuszczak³

et al. 2018

polp

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Slit ventricle syndrome (SVS) consists of clinical symptoms of intracranial hypertensive syndrome (IHS), which include severe, usually intermittent headaches; vomiting and possibly some degree of decreased consciousness; and impairment in hydrocephalic children with an apparently working ventriculoperitoneal shunt (VPS), without ventricular enlargement on computed tomography (CT) or magnetic resonance imaging (MRI). Signs of IHS include increasing head circumference and papilledema. The syndrome has been typically observed in children with neonatal or infant hydrocephalus, three to six years after VPS implantation. Therapeutic decisions are difficult and often depend only on the clinical presentation of IHS. There is much controversy about the treatment of SVS. Immediate shunt revision may pose a problem in putting the shunt system in the slit ventricles or removing the old shunt, which can be attached to the ependyma.

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Short-term dexamethasone treatment for symptomatic slit ventricle syndrome

Abstract: Dexamethasone appears to be a useful treatment in acutely increased intracranial pressure caused by SVS. It can provide temporary relief during the decision-making process of whether and when to perform surgery.

Cited by 28 publications

References 21 publications

Nonsurgical therapy for hydrocephalus: a comprehensive and critical review

Nonsurgical therapy for hydrocephalus: a comprehensive and critical review

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Slit ventricle syndrome: clinical and diagnostic pitfalls

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