Dynamics of Cerebrospinal Fluid Flow in Slit Ventricle Syndrome

Introduction: Although slit ventricle syndrome (SVS) is identified as a serious complication in shunt-treated hydrocephalus, cerebral spinal fluid (CSF) flow via external ventricular drainage (EVD) or shunts in SVS have not been studied up to now. Material and methods: A new apparatus (LiquoGuard (R); Moller-Medical, Fulda, Germany) was used for EVD in a child with SVS. The LiquoGuard actively controls CSF drainage, based on intracranial pressure (ICP). Results: To achieve well-tolerated clinical conditions, an ICP level of 4 mmHg was necessary; realizable by drainage rates between 0 and 35 mL/h. Drainage rate variations typically occurred with repetitive time intervals of 2 h causing a "saw tooth" shaped CSF flow pattern throughout 24 h. Discussion: SVS seems to be characterized largely by quickly varying CSF drainage demands. Whether this is a general phenomenon or just true for this case has still to be studied and needs further clarification.