Stephanie Cheok1, Jason Chen, Jorge Lazareff. 1. Department of Neurosurgery, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, 13-154 CHS, Los Angeles, CA, 90095, USA.
Abstract
INTRODUCTION: Overdrainage, siphoning, and slit-ventricle syndrome are well-documented complications of shunting in hydrocephalic patients. Despite the prevalence of these conditions, their mechanisms are still not fully understood. In this paper, the authors trace the concept of overdrainage and the related phenomena of siphoning and slit-ventricle syndrome. PURPOSE: To provide a historical overview of overdrainage and to reignite discussion of a topic that has been settled. METHODS AND RESULTS: A medical literature search and review were performed via Google Scholar. Of 565 publications, 3 primary papers were identified and a timeline was developed demonstrating the convergence of the aforementioned concepts. From the primary papers, 25 relevant publications were selected and further analyzed searching for hypothesis, evidence, and conclusions. CONCLUSION: Overdrainage, siphoning, and slit-ventricle syndrome are associated concepts that have converged into a pathophysiological theory where siphoning of CSF leads to overdrainage, which is then hypothesized to cause slit-ventricle syndrome in a small subset of patients. Our data suggests that while there have been numerous reports regarding overdrainage and its consequences, the evidence is not as robust as currently presumed and this subject requires prospective exploration.
INTRODUCTION: Overdrainage, siphoning, and slit-ventricle syndrome are well-documented complications of shunting in hydrocephalic patients. Despite the prevalence of these conditions, their mechanisms are still not fully understood. In this paper, the authors trace the concept of overdrainage and the related phenomena of siphoning and slit-ventricle syndrome. PURPOSE: To provide a historical overview of overdrainage and to reignite discussion of a topic that has been settled. METHODS AND RESULTS: A medical literature search and review were performed via Google Scholar. Of 565 publications, 3 primary papers were identified and a timeline was developed demonstrating the convergence of the aforementioned concepts. From the primary papers, 25 relevant publications were selected and further analyzed searching for hypothesis, evidence, and conclusions. CONCLUSION: Overdrainage, siphoning, and slit-ventricle syndrome are associated concepts that have converged into a pathophysiological theory where siphoning of CSF leads to overdrainage, which is then hypothesized to cause slit-ventricle syndrome in a small subset of patients. Our data suggests that while there have been numerous reports regarding overdrainage and its consequences, the evidence is not as robust as currently presumed and this subject requires prospective exploration.
Authors: Sara Iglesias; Bienvenido Ros; Álvaro Martín; Antonio Carrasco; Miguel Segura; Andrea Delgado; Francisca Rius; Miguel Ángel Arráez Journal: Childs Nerv Syst Date: 2016-08-05 Impact factor: 1.475