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Predicting slitlike ventricles in children on the basis of baseline characteristics at the time of shunt insertion.
[hydrocephalus with stenosis of the aqueduct of sylvius]
Slit
ventricle
syndrome
(
SVS
)
is
a
delayed
complication
of
shunt
insertion
and
occurs
only
in
children
with
slitlike
ventricles
after
shunt
placement
.
Although
SVS
appears
to
be
related
to
early
shunt
placement
,
its
predisposing
factors
are
largely
unknown
.
Baseline
data
in
737
children
who
had
received
shunts
were
obtained
from
the
databases
of
two
previous
clinical
trials
.
Ventricular
size
before
shunt
placement
and
at
the
last
routine
follow
up
was
measured
using
the
frontooccipital
horn
ratio
(
FOHR
)
.
Ventricles
with
an
FOHR
less
than
or
equal
to
0
.
2
at
follow
up
were
classified
as
slitlike
ventricles
.
A
univariate
analysis
was
performed
on
data
obtained
in
children
with
more
than
1
year
of
clinical
and
radiographic
follow
up
to
identify
risk
factors
for
developing
slitlike
ventricles
.
These
results
were
entered
into
a
multivariate
analysis
to
identify
independent
predictors
of
slitlike
ventricles
.
Two
hundred
forty-
four
children
had
more
than
1
year
of
clinical
and
radiographic
follow-up
data
.
The
23
patients
(
9
.
4
%
)
who
developed
slitlike
ventricles
had
shunts
inserted
at
a
younger
age
(
42
compared
with
134
days
,
p
=
0
.
09
)
and
were
more
likely
to
have
developed
hydrocephalus
secondary
to
infection
(
37
.
5
%
)
,
head
injury
(
25
.
0
%
)
,
or
aqueductal
stenosis
(
22
.
2
%
)
.
Slitlike
ventricles
were
seen
in
10
.
8
%
of
patients
with
differential-pressure
valves
,
10
.
5
%
of
patients
with
Delta
valves
,
and
3
.
6
%
of
patients
with
Orbis
-
Sigma
valves
(
p
=
0
.
007
)
.
Regression
analysis
supported
the
role
of
the
valve
type
in
developing
slitlike
ventricles
.
Age
at
shunt
insertion
and
valve
type
appear
to
be
the
modifiable
risk
factors
for
developing
slitlike
ventricles
.
If
the
authors
of
subsequent
studies
can
further
validate
these
conclusions
,
slow
-draining
valves
and
delayed
shunt
insertion
might
be
used
to
decrease
the
incidence
of
slitlike
ventricles
and
SVS
.
Diseases
Validation
Diseases presenting
"previous clinical trials"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
severe combined immunodeficiency
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