title: Slit ventricle syndrome and early-onset secondary craniosynostosis in an infant.
abstract: METHODS
  Female, 14 months
  
  
  METHODS
  Slit ventricle syndrome Symptoms: Hydrocephalus • lethargy and seizure • vomiting
  
  
  METHODS
  - Clinical Procedure: - Specialty: Pediatrics and Neonatology.
  
  
  OBJECTIVE
  Challenging differential diagnosis.
  
  
  BACKGROUND
  Shunt surgery is a common solution for hydrocephalus in infancy. Slit ventricle syndrome and secondary craniosynostosis are late-onset complications after shunt placement; these 2 conditions occasionally occur together.
  
  
  METHODS
  We report a case of early-onset secondary craniosynostosis with slit ventricle syndrome after shunt surgery in an infant, which led to a catastrophic increase in intracranial pressure (ICP). A 4-month-old girl with a Dandy-Walker malformation underwent a ventriculoperitoneal shunt procedure. Her head circumference (HC) gradually decreased to approximately the 5(th) percentile for her age group after shunt surgery. Seven months later, she developed increased ICP symptoms and underwent a shunt revision with a diagnosis of shunt malfunction. Her symptoms were temporarily relieved, but she repeatedly visited the emergency room (ER) for the same symptoms and finally collapsed, with an abrupt increase in ICP, 3 months later. Further evaluation revealed the emergence of sagittal synostosis at 7 months after initial shunt surgery. After reviewing all clinical data, slit ventricle syndrome combined with secondary craniosynostosis was diagnosed. Emergent cranial expansion surgery with shunt revision was performed, and the increased ICP signs subsided in the following days.
  
  
  CONCLUSIONS
  Clinical suspicion and long-term HC monitoring are important in the diagnosis of slit ventricle syndrome and secondary craniosynostosis after shunt surgery, even in infants and young children.
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Hyun Gee
authors.initials: HG
authors.lastname: Ryoo
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Diagnostic Radiology, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Cheon
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Ji Yeoun
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Kyu-Chang
authors.initials: KC
authors.lastname: Wang
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Phi
keywords: Cerebrospinal Fluid Shunts; Craniosynostosis; Hydrocephalus; Slit Ventricle Syndrome