Changes in intracranial pressure after calvarial expansion surgery in children with slit ventricle syndrome

The effect of calvarial expansion on symptom relief and intracranial pressu re (ICP) in three children with slit ventricle syndrome (SVS) and intracran ial hypertension despite a functioning ventricular shunt is reported. These children presented with a clinical picture of SVS, accompanied by slit-lik e ventricles on cranial computer tomography scan and intracranial hypertens ion. Calvarial expansion was performed by mans of an anterior approach in o ne case and a posterior approach (modified tiara plastic) in the other two cases. After calvarial expansion, symptoms of intracranial hypertension wer e abolished in one case and markedly reduced in two cases (observation peri od 25-36 months). Comparison of ICP before and after surgery was performed by means of new software (Sensometrics (TM) Pressure Analyser, version 1.2) that revealed a significant reduction in the number of abnormal ICP elevat ions after surgery. The results were not accompanied by changes in the size of the cerebral ventricles. This study demonstrates that in children with SVS and intracranial hypertension despite a functioning shunt, calvarial ex pansion may reduce ICP and produce long-lasting symptom relief. In these ca ses, we suggest that intracranial hypertension was caused by compromised in tracranial volume. Copyright (C) 2001 S. Karger AG, Basel.