slit ventricle syndrome

Etiology

• occurs in a minority of patients with ventriculostomy

Pathology

• shunt is nearly blocked, but still barely flowing
• absence of CSF within the ventricles
• expansion of the brain
• increased intracranial pressure (may be very high)

Clinical manifestations

• usually presents years after shunt placement or revision
• headache
• lethargy (variable)
• nausea/vomiting (variable)
• symptoms may be intermittent
• over drainage may be associated with positional headaches relieved when supine

Radiology

• very small or 'slit-like' ventricles on neuroimaging (MRI of brain, CT of brain)

Management

• observation (minimally symptomatic)
• treat as migraine
• ventriculostomy revision
• temporarily block ventriculostomy drainage to expand the ventricles
  • careful monitoring of intracranial pressure
  • risk of coma
• endoscopic third ventriculostomy for aqueductal stenosis

More general terms

• postoperative complication
• disease/disorder primarily affecting brain
• syndrome