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Neuropathological findings in a child with slit ventricle syndrome
1Department of Pathology, Health Sciences Centre, and Manitoba Institute of Child Health, Winnipeg, Canada. delbigi@cc.umanitoba.ca
Insights
Slit ventricle syndrome in shunted hydrocephalic children is poorly understood. Histopathology reveals glial adhesions and shunt obstruction, but periventricular astrogliosis may not be the primary cause.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Histopathology
Background:
- Shunt placement is common for hydrocephalus in children.
- Slit ventricle syndrome (SVS) is a rare complication of shunted hydrocephalus.
- The histopathological features of SVS are not well-documented.
Observation:
- A 10-year-old girl with a history of infantile meningitis and shunt placement developed SVS.
- She experienced headaches, respiratory arrest, and was found to have very small ventricles on CT scan.
- Post-mortem examination revealed small ventricles with glial adhesions, aqueductal obstruction, and a completely blocked shunt catheter.
Findings:
- Autopsy confirmed SVS with significant neuropathological findings.
- Periventricular white matter showed reactive astroglia, but this was not more severe than in other hydrocephalic children with shunt failure.
- Glial adhesions within the small ventricles were noted.
Implications:
- Periventricular astrogliosis may not be the sole or primary determinant of SVS.
- This case highlights the complex histopathological changes in SVS.
- Further research is needed to fully understand the pathogenesis of SVS.
Abstract:
The histopathological changes in shunted hydrocephalic children with slit ventricle syndrome have never been described. Periventricular gliosis is presumed to be an important feature. A girl who was shunted in infancy following meningitis developed headaches at 10 years of age and suffered a respiratory arrest, from which she was resuscitated. CT scan of the head showed very small ventricles. A diagnosis of slit ventricle syndrome was made. She died 33 h later. Autopsy revealed a large head and brain, small ventricles with glial adhesions, obstruction of the cerebral aqueduct, complete obstruction of the shunt catheter and reactive astroglia in the periventricular white matter. The latter change was no more severe than in hydrocephalic children with enlarged ventricles who have died following shunt failure. Periventricular astrogliosis may not necessarily be the major determinant of the slit ventricle syndrome.