Reexpandability of the ventricular system of hydrocephalic children in the event of shunt occlusion.

摘要

INTRODUCTION: To estimate intracranial volume-buffering capacity in the event of shunt occlusion, the reexpandabilty of the lateral ventricles and clinical manifestations were examined in shunt-dependent hydrocephalic children. MATERIAL AND METHODS: This retrospective study was performed in 38 children who displayed acute deterioration due to spontaneous shunt obstruction. At the time of shunt obstruction, patients with small lateral ventricles [small ventricle (SV) group: Evans' index 0.35, n=25]. All patients in the SV group were 3 years or older at the time of shunt obstruction or had a long period (5.2 years) between initial shunting and shunt occlusion. Their Evans' index was less than 0.33 prior to shunt obstruction. CONCLUSIONS: While a shunt is functioning, the factors predictive of reduced ventricular reexpandability include (1) a lateral ventricular size smaller than 0.33 on the Evans' index and (2) either an age of more than 3 years in children who have undergone initial shunting at less than 1 year of age or over 5 years of the period after initial shunting.