Abstract
A case of an 8-year-old boy with slit-ventricle syndrome (SVS) is reported. The child received a ventriculo-peritoneal shunt operation for postmeningitic hydrocephalus at 9 months of age. From 4 years of age, he frequently showed intermittent spells of severe headache, vomiting, respiratory disturbance, and drowsiness. The peritoneal catheter was changed to a high pressure one. However, similar symptoms recurred 2 years after this procedure. On readmission the patient showed normal development and was neurologically free of symptoms in the intervals between attacks. A computed tomography (CT) scan taken during an attack showed collapsed ventricles. Epidural pressure monitoring demonstrated significant elevation of the intracranial pressure. The symptoms became unmanageable in spite of mannitol infusion. Another CT scan demonstrated slightly enlarged lateral ventricles compared with the previous scan. Emergent revision of the shunt system was performed. The ventricular catheter was obstructed by a piece of connective tissue, and thus was replaced with a new ventricular catheter with an anti-siphon valve. The postoperative course was uneventful and the symptoms completely disappeared. In many reported cases of SVS, intermittent headache and vomiting are the main symptoms. This case is unusual because of the accompanying respiratory disturbance and remarkable elevation of the intracranial pressure. The reason for the intermittent occurrence of the symptoms is discussed, with a review of the literature in regard to the etiology of SVS.
