Alternative uses for the subgaleal shunt in pediatric neurosurgery.
The subgaleal shunt has been used for the temporary bypass of the normal cerebrospinal fluid (CSF) pathways. We retrospectively reviewed all subgaleal shunts placed at the Children's Hospital, Birmingham, Ala., USA, from 1997 to the present and examined all uses (e.g. indication, length of follow-up) of the subgaleal shunt outside its use for temporary CSF diversion in premature infants with intraventricular hemorrhage and subsequent hydrocephalus. The average length of survival of the primary subgaleal shunt in this population was 32.2 days. We have had good success with subgaleal shunts in children with malignant brain tumors, intraventricular abscesses, chronic truncal wounds, chronic subdural hygromas and meningitis. However, the greatest utility has been in those scenarios in which the peritoneal cavities were not currently, but with time would be, candidates for distal shunt implantation. Examples of these instances are patients with hydrocephalus and necrotizing enterocolitis or hydrocephalus and preoperative abdominal wall pathology such as omphalocele.
Tubbs
R Shane
RS
Department of Cell Biology, University of Alabama at Birmingham, USA. richard.tubbs@ccc.uab.edu
Smyth
Matthew D
MD
Wellons
John C
JC
Blount
Jeffrey P
JP
Grabb
Paul A
PA
Oakes
W Jerry
WJ
D001927:Brain Diseases / Q000150:complications* / Q000601:surgery*; D002550:Cerebral Veins / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D019635:Neurosurgical Procedures / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010372:Pediatrics / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors