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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Visual acuity loss and sixth nerve palsy as the only manifestations of slit vent...
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Vol. 97. Issue 1.
Pages 40-43 (January 2022)
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Vol. 97. Issue 1.
Pages 40-43 (January 2022)
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Visual acuity loss and sixth nerve palsy as the only manifestations of slit ventricle syndrome
Pérdida de agudeza visual y parálisis de VI nervio craneal como únicas manifestaciones de un síndrome de colapso ventricular
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V.M. Asensio-Sánchez
Corresponding author
, G.E. Pacheco-Callirgos, J. Valentín-Bravo, L. García-Onrubia
Servicio de Oftalmología, Hospital Clínico Universitario, Valladolid, Spain
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Abstract

The case is presented of a girl diagnosed with obstructive hydrocephalus due to pilomyxoid astrocytoma, which required a ventriculoperitoneal shunt (VPS) at the age of 5 years and 10 months. Two months later, magnetic resonance imaging of the brain did not show ventriculomegaly or other signs of increased intracranial pressure. At the age of 6 years and 2 months, a rapid onset of bilateral visual acuity loss developed and she was diagnosed with slit ventricle syndrome. Despite valve revisions of the VPS, she developed an abrupt decline of visual acuity to hand motion at 10 cm. Fundus examination revealed bilateral optic atrophy. She did not report any other systemic symptoms suggesting increased intracranial pressure, such as headache, nausea, vomiting, lethargy, irritability, or altered levels of consciousness.

Keywords:
Slit ventricle syndrome
Obstructive hydrocephalus
Optic atrophy
Ventriculoperitoneal shunt
Ventriculomegaly
Intracranial hypertension
Sixth nerve palsy
Pilomyxoid astrocytoma
Resumen

Se describe una niña con hidrocefalia obstructiva por un astrocitoma pilomixoide, que requirió implantar una derivación ventrículo-peritoneal (DVP) a los 5 años y 10 meses de edad. Dos meses después, la resonancia magnética cerebral no mostró ventriculomegalia ni otros signos de aumento de la presión intracraneal. A la edad de 6 años y 2 meses desarrolló una rápida disminución de la agudeza visual bilateral siendo diagnosticada de síndrome de colapso ventricular. A pesar de las revisiones valvulares de la DVP, se produjo una disminución abrupta de la agudeza visual a movimientos de mano a 10 cm. El examen del fondo de ojo reveló atrofia óptica bilateral. No refirió otros síntomas sistémicos que sugirieran un aumento de la presión intracraneal, como dolor de cabeza, náuseas, vómitos, letargia, irritabilidad o niveles alterados de conciencia.

Palabras clave:
Síndrome de colapso ventricular
Hidrocefalia obstructiva
Atrofia óptica
Derivación ventrículo-peritoneal
Ventriculomegalia
Hipertensión intracraneal
Paresia de VI nervio craneal
Astrocitoma pilomixoide

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