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Ventriculosubgaleal shunting—a comprehensive review and over two-decade surgical experience

  • Seif Eid
  • Joe Iwanaga
  • Rod J. Oskouian
  • Marios Loukas
  • W. Jerry Oakes
  • R. Shane Tubbs
Review Paper

Abstract

Introduction

The subgaleal space is the fibroareolar layer found between the galea aponeurotica and the periosteum of the scalp. Due to its elastic and absorptive capabilities, the subgaleal space can be used as a shunt to drain excess cerebrospinal fluid from the ventricles. A subgaleal shunt consists of a shunt tube with one end in the lateral ventricles while the other end is inserted into the subgaleal space of the scalp. This will allow for the collection and absorption of excess cerebrospinal fluid. Indications for ventriculosubgaleal shunting (VSG) include acute head trauma, subdural hematoma, and malignancies.

Discussion

VSG shunt is particularly advantageous for premature infants suffering from post-hemorrhagic hydrocephalus due to their inability to tolerate long-term management such as a ventriculoperitoneal shunt. Complications include infection and shunt blockage. In comparison with other short-term treatments of hydrocephalus, the VSG exhibits significant advantages in the drainage of excess cerebrospinal fluid. VSG shunt is associated with lower infection rates than other external ventricular drain due to the closed system of CSF drainage and lack of external tubes.

Conclusion

This review discusses the advantages and disadvantages of the VSG shunt, as well as our personal experience with the procedure.

Keywords

Subgaleal space Hydrocephalus Ventriculosubgaleal shunt Complications Indications 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Seif Eid
    • 1
  • Joe Iwanaga
    • 2
  • Rod J. Oskouian
    • 3
  • Marios Loukas
    • 1
  • W. Jerry Oakes
    • 4
  • R. Shane Tubbs
    • 1
    • 2
  1. 1.Department of Anatomical SciencesSt. George’s UniversitySt. George’sGrenada
  2. 2.Seattle Science FoundationSeattleUSA
  3. 3.Swedish Neuroscience InstituteSwedish Medical CenterSeattleUSA
  4. 4.Children’s Hospital of AlabamaBirminghamUSA

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