title: Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt?
abstract: Symptomatic shunt malfunction without ventricular enlargement is known as slit ventricle syndrome (SVS). Patients presenting with this syndrome are not a homogeneous group. Of the 5 different types classified by Rekate, Type 1 is caused by CSF overdrainage and is associated with low pressures; Types 2 and 3 are associated with shunt blockage and elevated CSF pressures; Type 4 is cephalocranial disproportion that increases brain parenchymal pressure but not CSF pressure; and Type 5 is headache unrelated to shunt function. The low and normal CSF pressure types are relatively well understood, but the high-pressure forms are more problematic. In the high-pressure forms of SVS it is said that the lack of ventricular dilation is related to a reduction in brain compliance analogous to idiopathic intracranial hypertension or pseudotumor cerebri. Despite this, there is little evidence in the literature to support this conjecture. With this in mind, 3 cases of SVS associated with elevated CSF pressure are presented. The MR venogram findings and hemodynamics of these 3 cases are shown to be identical to those of pseudotumor cerebri. A literature review indicates that an underlying venous impairment may be functioning in the patients who re-present with small ventricles following shunt malfunction.
authors.affiliation: Department of Medical Imaging, John Hunter Hospital, and Newcastle University Faculty of Health, Callaghan Campus, Newcastle, Australia.
authors.forename: Grant A
authors.initials: GA
authors.lastname: Bateman
mesh_terms: D000328:Adult; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D004868:Equipment Failure; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011559:Pseudotumor Cerebri / Q000134:cerebrospinal fluid / Q000209:etiology*; D056124:Slit Ventricle Syndrome / Q000134:cerebrospinal fluid / Q000145:classification / Q000209:etiology*; D055815:Young Adult