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

Abstract

<jats:sec> <jats:title>OBJECT</jats:title> <jats:p>The ideal treatment for subdural hematomas (SDHs) in infants remains debated. The aim of this study was to analyze the safety and efficiency of subduro-subgaleal drainage in SDH.</jats:p></jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>The authors conducted a single-center open-label study between August 2011 and May 2012. Data were prospectively collected in a database and retrospectively analyzed.</jats:p></jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Eighteen patients (male/female ratio 1.25) with a median age of 5 months were surgically treated. All had preoperative symptoms of intracranial hypertension or seizures. The SDH was bilateral in 16 cases, with a median width of 12 mm. Success of the procedure was noted in 14 of the 18 patients. There was no intraoperative complication or postoperative infection. Drainage failure was attributable to suboptimal positioning of the subdural drain in 2 cases and to migration in 1 case.</jats:p></jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Subduro-subgaleal drainage is an efficient treatment that could be proposed as an alternative to external subdural drainage or subduroperitoneal drainage.</jats:p></jats:sec>

Intraventricular Fluid Injection as a Novel Treatment of Subdural Fluid Collection after VP Shunt Overdrainage: A Case Report

“…Blauwblomme et al, reported a series of 18 patients of non-traumatic chronic subdural hematomas treated with subdural-subgaleal shunts in 2015. The result have a success rate of 78%, but the drawback of this procedure is the patients need to keep horizontally position during the postoperative period [6].…”

“…The ideal surgical treatment of subdural fluid collection for children remains controversial. Different studies propose the use of percutaneous transfontanellar puncture, external drainage, subduroperitoneal shunt, craniotomy and subgaleal shunt [6]. Attachment of anti-siphon device and shunt valve replacement to a programmable one also help reducing the risk of subdural recollections [7].…”