التفاصيل البيبلوغرافية
| العنوان: |
Subtemporal Decompression in Resistant Slit Ventricle Syndrome in Children: An Observational Study and Survival Analysis. |
| المؤلفون: |
Khan, Mehdi, Craven, Claudia Louise, Tahir, Muhammad Zubair |
| المصدر: |
Pediatric Neurosurgery; 2023, Vol. 58 Issue 6, p420-428, 9p |
| مصطلحات موضوعية: |
SURVIVAL analysis (Biometry), SYNDROMES in children, CHILD patients, SCIENTIFIC observation, SURGICAL anastomosis, CEREBROSPINAL fluid shunts |
| مستخلص: |
Introduction: Slit ventricle syndrome (SVS) remains a challenging problem in the early-shunted paediatric population. Various surgical and non-surgical treatments have been devised for this condition. However, there is currently no gold standard for its optimal management. Among various treatment modalities, subtemporal decompression (STD) is often performed as a last resort. We present our experience of STD in paediatric patients with SVS in whom initial treatment with programmable valves and anti-syphon device were not successful. Methods: This is a single-centre retrospective observational study and survival analysis. Patients who underwent STD for SVS were included. Pre- and post-operative imaging data and clinical outcomes were collected. Results: There were 20 patients (12 M, 8 F) with a mean age of 9 years (SD: 4) at first STD. 90% (n = 18) of patients had multiple shunt revisions pre-STD. At first STD, 70% (n = 14) and 30% (n = 6) of patients had unilateral or bilateral STD, respectively. STD led to a reduction in the frequency of shunt revisions in 60% (n = 12) of patients. The median time required before further STD, shunt surgery, or cranial vault surgery was 14 months. The median time before a further STD was required (either revision or contralateral side) was 89 months. At a median follow-up of 66.5 months (range: 1–159), 65% (n = 13) of patients had improvement in symptoms. Conclusions: A large proportion of patients with persistent SVS symptoms, refractory to multiple shunt revisions, benefitted from STD in combination with shunt optimization. It was also safe and well-tolerated. Therefore, in patients who have multiple failed shunts, STD may reduce the morbidity associated with further shunt revisions and can significantly improve symptomatology. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
