Treatment of cephalocranial disproportion in shunt-induced slit ventricle syndrome with cranial vault distraction osteogenesis.
BACKGROUND
Slit ventricle syndrome (SVS) is a known late complication of shunting procedures. Some patients develop cephalocranial disproportion (CCD) that will require surgical treatment to increase craniocerebral compliance.


METHODS
We performed cranial vault distraction osteogenesis to treat 2 teenage patients who presented with SVS, increased intracranial pressure and CCD. Bilateral temporo-parieto-occipital craniotomies were performed.


RESULTS
Both patients successfully completed distraction and consolidated without the need for bone grafting. Postoperatively, both patients showed an increase in intracranial and intraventricular volume, as well as decreased shunt revisions. One patient had improvement of her headaches, while the other continues to have chronic headaches.


CONCLUSIONS
Distraction osteogenesis is an option to expand the cranial vault in older children with SVS and CCD, in which the traditional cranial vault expansion would be a challenge and may or may not provide adequate expansion.
Dell Children's Medical Center of Central Texas, Austin, Tex., USA.
Maria Helena N
MH
de Lima
Raymond J
RJ
Harshbarger
Timothy M
TM
George
D000293:Adolescent; D005260:Female; D006801:Humans; D019857:Osteogenesis, Distraction / Q000379:methods*; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D056124:Slit Ventricle Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*