Abstract
Objective
The authors describe a simple technique to reduce the incidence of cerebrospinal fluid (CSF) leak following endoscopic third ventriculostomy and other neuroendoscopic procedures.
Methods
After the scalp incision, the galea and pericranium are reflected in a single layer after the scalp incision which is then closed in a watertight fashion after the procedure is completed. The securely closed flap prevents minor CSF leaks which would have otherwise required intermittent CSF drainage procedures.
Conclusion
This simple procedural modification is effective in children with thin cortical mantle and large ventricles who are otherwise highly susceptible for CSF leak in the postoperative period.
Similar content being viewed by others
References
Cinalli G (2004) Endoscopic third ventriculostomy. In: Cinalli G, Maixner WJ, Sainte-Rose C (eds) Pediatric hydrocephalus. Springer, Milan, pp 361–388
Cinalli G, Spennato P, Ruggiero C, Aliberti F, Trischitta V, Buonocore MC, Cianciulli E, Maggi G (2007) Complications following endoscopic intracranial procedures in children. Childs Nerv Syst 23:633–644
Kombogiorgas D, Sgouros S (2006) Assessment of the influence of operative factors in the success of endoscopic third ventriculostomy. Childs Nerv Syst 22:1256–1262
Navarro R, Gil-Parra R, Reitman AJ, Olavarria G, Grant JA, Tomita T (2006) Endoscopic third ventriculostomy in children: early and late complications and their avoidance. Childs Nerv Syst 22:506–513
Nishiyama K, Mori H, Tanaka R (2003) Changes in cerebrospinal fluid hydrodynamics following endoscopic third ventriculostomy for shunt dependent noncommunicating hydrocephalus. J Neurosurg 98:1027–1031
Pereta P, Ragazzi P, Galarza M, Genitori L, Giordano F, Mussa F, Cinalli G (2006) Complications and pitfalls of neuroendoscopic surgery in children. J Neurosurg 105(suppl 3):187–193
Schroeder HWS, Niendorf WR, Gaab MR (2002) Complications of endoscopic third ventriculostomy. J Neurosurg 96:1032–1040
Teo C, Rahman S, Boop FA, Cherny B (1996) Complications of endoscopic neurosurgery. Childs Nerv Syst 12:248–253
Teo C (2004) Complications of endoscopic third ventriculostomy. In: Cinalli G, Maixner WJ, Sainte-Rose C (eds) Pediatric hydrocephalus. Springer, Milan, pp 411–420
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mohanty, A., Suman, R. Role of galeal–pericranial flap in reducing postoperative CSF leak in patients with intracranial endoscopic procedures. Childs Nerv Syst 24, 961–964 (2008). https://doi.org/10.1007/s00381-008-0594-8
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-008-0594-8