Pathophysiology of isolated lateral ventriculomegaly in shunted myelodysplastic children.
Eight myelodysplastic children developed isolated lateral ventriculomegaly following shunt insertion for progressive hydrocephalus after closure of a myelomeningocele. In all patients a low-pressure distal slit valve (Uni-shunt) system preceded development of an isolated contralateral ventricle. Six of 8 children required a second contralateral shunt for a symptomatic isolated ventricle. Magnetic resonance imaging demonstrated a collapsed ventricle ipsilateral to the shunt secondary to distortion of the foramen of Monro. This was clearly depicted using three-dimensional color reconstructions of the ventricular anatomy. Low-pressure distal slit valves should be avoided in myelodysplastic children to prevent postshunt ventricle isolation.
Berger
M S
MS
University of Washington Medical Center, Seattle.
Sundsten
J
J
Lemire
R J
RJ
Silbergeld
D
D
Newell
D
D
Shurtleff
D
D
D002552:Cerebral Ventricles / Q000473:pathology / Q000503:physiopathology; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation*; D002648:Child; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008591:Meningomyelocele / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010537:Peritoneum; D011183:Postoperative Complications / Q000473:pathology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed