title: Subdural to subgaleal shunts: alternative treatment in infants with nonaccidental traumatic brain injury?
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Subduro-subgaleal drainage is an efficient treatment that could be proposed as an alternative to external subdural drainage or subduroperitoneal drainage.
authors.affiliation: Departments of 1 Pediatric Neurosurgery and.
authors.forename: Thomas
authors.initials: T
authors.lastname: Blauwblomme
authors.forename: Federico
authors.initials: F
authors.lastname: Di Rocco
authors.forename: Marie
authors.initials: M
authors.lastname: Bourgeois
authors.forename: Kevin
authors.initials: K
authors.lastname: Beccaria
authors.forename: Giovanna
authors.initials: G
authors.lastname: Paternoster
authors.forename: Juliette
authors.initials: J
authors.lastname: Verchere-Montmayeur
authors.forename: Christian
authors.initials: C
authors.lastname: Sainte-Rose
authors.forename: Michel
authors.initials: M
authors.lastname: Zerah
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Puget
mesh_terms: D001930:Brain Injuries / Q000150:complications*; D016208:Databases, Factual; D004322:Drainage; D005260:Female; D006408:Hematoma, Subdural / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D019586:Intracranial Hypertension / Q000209:etiology; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D012449:Safety; D012640:Seizures / Q000209:etiology; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: SDH = subdural hematoma; SDP = subduroperitoneal; hydrocephalus; nonaccidental traumatic brain injury; subdural hematomas; subduroperitoneal shunts; subgaleal shunts; trauma