Classification of slit-ventricle syndromes using intracranial pressure monitoring.

The term slit-ventricle syndrome appears to have different meanings to different authors. This study proposes a sublcassification of headaches in shunted children based on data obtained from chronic monitoring of intracranial pressure in 7 symptomatic children. Five distinct syndromes are identified: (1) intermittent, extremely low pressure headaches that are analogous to spinal headaches, (2) intermittent proximal obstruction, (3) shunt failure with small ventricles ('normal volume hydrocephalus'), (4) intracranial hypertension with working shunts (hydrocephalic pseudotumor), and (5) headaches unrelated to shunt function. We would prefer to limit the use of the term slit-ventricle syndrome to the triad of intermittent headaches lasting 10-30 min, smaller than normal ventricles on imaging studies, and slow refill of shunt-pumping devices. In other situations, a description relating to the presumed pathogenesis should be used.