Pathophysiology of Isolated Lateral Ventriculomegaly in Shunted Myelodysplastic Children

Authors:
  • JSJ. Sundsten
    J. Sundsten
  • RLR.J. Lemire
    R.J. Lemire
  • DSDaniel Silbergeld
    Daniel Silbergeld
  • DNDavid Newell
    David Newell
  • DSD. Shurtleff
    D. Shurtleff
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Abstract
Eight myelodysplastic children developed isolated lateral ventriculomegaly following shunt insertion for progressive hydrocephalus after closure of a myelomeningocele. In all patients a low-pressure distal slit valve (Unishunt) system preceded development of an isolated contralateral ventricle. Six of 8 children required a second contralateral shunt for a symptomatic isolated ventricle. Magnetic resonance imaging demonstrated a collapsed ventricle ipsilateral to the shunt secondary to distortion of the foramen of Monro. This was clearly depicted using three-dimensional color reconstuctions of the ventricular anatomy. Low-pressure distal slit valves should be avoided in myelodysplastic children to prevent postshunt ventricle isolation.