Long-term external drainage for subdural collections in infants

Abstract

The treatment of subdural collections in infants remains controversial. In order to evaluate the treatment guidelines that we developed on the basis of our earlier experience, we have reviewed the results obtained in 31 consecutive infants with symptomatic chronic and subacute subdural collections treated with external drainage. Using our guidelines for removal of the drains, there was only a very low rate of permanent shunting (4/31), with a low complication rate and good clinical results. However, the long period of external drainage, and therefore of hospitalization, might make if general application of these guidelines problematic.

External Subdural Drainage in the Treatment of Infantile Chronic Subdural Hematoma

“…23 The best result of continuous external subdural drainage was reported by Van Calenbergh et al, with a very low rate of permanent shunting (4 of 31), a low complication rate, and good clinical results. 34 The period for which the subdural drain was left in place was less than 10 days in some series. 7,23 This period was reported as being from 1 to 29 days, with a mean of 12 days.…”

Subdural to subgaleal shunts: alternative treatment in infants with nonaccidental traumatic brain injury?

“…2,8,16 Nevertheless, drainage must be maintained for a long period (median 6-15 days), with hospitalization in the intensive care unit and hydro-electrolytic compensation; therefore, the economic cost is high and must be taken into account along with the actual economic context. Some authors still advocate the use of minicraniotomy given its good success rate, but this method is quite invasive.…”

A new catheter for subduro-peritoneal shunting

“…Subdural tapping [1,9,11,12,17], craniotomy and removal of membranes [9,15], drainage [5,6,8,25], and shunting from the subdural space [3,4,7,8,10,11,15,16,17,18,20,23,24] have been used in the treatment of chronic infantile subdural hematomas or effusions. Subduro-peritoneal (SP) shunting is one of the definitive treatment modalities in the management of chronic subdural collections.…”