Risk factors associated with slit ventricle syndrome after ventriculoperitoneal shunt surgery

Objective: Slit ventricle syndrome (SVS) is defined as a slit-like appearance of the lateral ventricles with associated symptoms such as headache, vomiting, or drowsiness. The study investigated the risk factors associated with the incidence of SVS following ventriculoperitoneal shunt surgery.Methods: We retrospectively reviewed the medical records of patients who underwent ventriculoperitoneal shunt surgery from January 2011 to 2019 at a single institution. SVS was diagnosed by a slit-like appearance of the lateral ventricles and a low Evan’s ratio (<0.25) on follow-up radiologic images. Results: SVS was diagnosed in 53 (18.2%) of 292 patients who underwent ventriculoperitoneal shunt surgery. The mean age of patients with SVS (48.3 years; range, 4–85 years) was significantly lower than the mean age of those without SVS (58.4 years; range, 0.5–85 years) (p=0.024). Male patients showed a slightly higher incidence of SVS, but the result was not statistically significant. Patients who had hydrocephalus with vascular causes (e.g. subarachnoid hemorrhage and intracranial hematoma) showed a significantly lower incidence of SVS than those with non-vascular causes (p=0.002).Conclusion: The incidence of SVS was higher in younger patients and in those with a non-vascular cause of hydrocephalus.