Operative treatment of extremely large bilateral subdural effusions in infancy

Summary

In some cases of subdural effusions the common methods of treatment (subdural punctures, burr holes, shunting procedures and standard craniotomy) are ineffective. Usually in these cases a marked craniocerebral disproportion causes the persistence of the hygroma. In 14 of these cases with bilateral effusions the authors have used effectively an operative procedure, in which not only the inner membrane is removed but also the dural sac and the cranium is resected down to a size, where an optimal adaptation to the brain volume is achieved. The operative technique is illustrated and the long term results are presented. No major operative and postoperative complications occurred. The indication for this operative procedure is discussed with special regard to the current concepts in the literature.