المؤلفون: Khan, Mehdi¹ (AUTHOR), Craven, Claudia Louise¹ (AUTHOR), Tahir, Muhammad Zubair¹ (AUTHOR)

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]

المؤلفون: Dyson, Edward W¹ (AUTHOR) edwarddyson@nhs.net, Craven, Claudia L¹ (AUTHOR), Tisdall, Martin M^1,2 (AUTHOR), James, Gregory A^1,2 (AUTHOR)

المصدر: Child's Nervous System. Sep2020, Vol. 36 Issue 9, p1821-1823. 3p.

مصطلحات موضوعية: *SOCIAL distancing, *COVID-19 pandemic, *PEDIATRIC emergencies, *COHORT analysis, *SCIENTIFIC observation