Effect of Temporary Subdural-Peritoneal Shunt on Subdural Effusion with Subarachnoid Effusion

Abstract

A special entity called subdural effusion with ruptured subarachnoid effusion, which was diagnosed by CT, air study, and RI cisteraography, was observed in 14 children of up to 10 months of age. 10 cases that showed symptoms of increased intracranial pressure (ICP) were treated by temporary subdural-peritoneal (S-P) shunt, and the remaining 4 cases that showed no symptoms of increased ICP were treated conservatively. 9 of the 10 cases treated by S-P shunt and 2 of the 4 cases treated conservatively showed good results. Poorly balanced absorption of cerebrospinal fluid (CSF) during the special transitional period of the CSF dynamics may be thought to be a pathogenetic factor.

Computer Tomographic Long-Time Results after Surgical Removal of Subdural Fluid Collections in Infancy and Childhood

“…Compression by the subdural mass and constricting of the brain by membranes may be the causing factors as Rabe et al [11] had described. No correlation existed in our cases between these CT find ings and the clinical outcome in accordance with reports from other authors [5,15]. The clinical outcome was more dependent of the under lying disease, e.g.…”

Complications of subduroperitoneal shunting

“…Although removal of the SP shunts after resolution of the subdural fluid collection has been advocated or achieved by some others [1,5,13,14,21,24], Litofsky et al [11] did not observe an adverse effect in 37 patients who had not had their shunts removed. The interval between the shunt insertion and removal ranged from 4 to 12 weeks in studies reported in the literature [1,5,14].…”

“…Various treatment modalities have been used in the management of infantile chronic subdural fluid collections, such as subdural taps [1,12], evacuation of the hematoma and excision of the membranes by a wide craniotomy [9], internal drainage of the subdural fluid into a body cavity such as the pleura or the peritoneum [4,5,20], subgaleal shunt [18] and subdural drainage [7,8]. Although subduroperitoneal (SP) shunts have been widely used in the management of subdural fluid collections [3,5,7,8,11,13,14,24], publications on their complications are few in number. In this study, we retrospectively reviewed the complications of SP shunting performed in our institution.…”

Management of subarachnoid fluid collection in infants based on a long-term follow-up study

“…Subdural taps may also result in subdural effusion due to traumatic subarachnoid rupture. For patients whose course is complicated by an expanding or symptomatic subdural fluid collection, we usually make burr holes and irrigate, but if the clinical symptoms do not improve and the fluid collection does not decrease in size, we insert a unilateral subdural-peritoneal shunt [4,21,39]. The shunt does not necessarily need to be removed after resolution of the fluid collection.…”