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

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A Correction to this article was published on 25 August 2018

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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.


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.


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

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Change history

  • 25 August 2018

    The original version of this article unfortunately contained an error.


  1. Aschoff A, Kremer P, Hashemi B, Kunze S (1999) The scientific history of hydrocephalus and its treatment. Neurosurg Rev 22:67–93

    Article  PubMed  CAS  Google Scholar 

  2. Drapkin A, Levine ME, Yang WC (1980) Ventriculo-subgaleal shunt: evaluation by computed tomography. Acta Neurochir 55:107–115

    Article  PubMed  CAS  Google Scholar 

  3. Hansasuta A, Boongird A (2007) Ventriculo-subgaleal shunting: step-by-step technical note. J Med Assoc Thail 90:473–478

    Google Scholar 

  4. Nee LS, Harun R, Sellamuthu P, Idris Z (2017) Comparison between ventriculosubgaleal shunt and extraventricular drainage to treat acute hydrocephalus in adults. Asian J Neurosurg 12:659–663

    Article  PubMed  PubMed Central  Google Scholar 

  5. Reinprecht A, Dietrich W, Berger A, Bavinzski G, Weninger M, Czech T (2001) Posthemorrhagic hydrocephalus in preterm infants: long-term follow-up and shunt-related complications. Childs Nerv Syst 17:663–669

    Article  PubMed  CAS  Google Scholar 

  6. Rizvi SA, Wood M (2010) Ventriculosubgaleal shunting for post-haemorrhagic hydrocephalus in premature neonates. Pediatr Neurosurg 46:335–339.

    Article  PubMed  Google Scholar 

  7. Savitz MH, Malis LI (2000) Subgaleal shunting: a 20-year experience. Neurosurg Focus 9:1–5.

    Article  Google Scholar 

  8. Seery GE (2002) Surgical anatomy of the scalp. Dermatol Surg 28:581–587.

    Article  PubMed  Google Scholar 

  9. Tubbs RS, Smyth MD, Wellons JC III, Blount JP, Grabb PA, Oakes WJ (2003) Alternative uses for the subgaleal shunt in pediatric neurosurgery. Pediatr Neurosurg 39:22–24.

    Article  PubMed  Google Scholar 

  10. Tubbs RS, Smyth MD, Wellons JC III, Blount JP, Grabb PA, Oakes WJ (2003) Life expectancy of ventriculosubgaleal shunt revisions. Pediatr Neurosurg 38:244–246.

    Article  PubMed  Google Scholar 

  11. Tubb RS, Banks JT, Soleau S, Smyth MD, Wellons JC, Blount JP, Grabb PA, Oakes WJ (2004) Complications of ventriculosubgaleal shunts in infants and children. Childs Nerv Syst 21:48–51.

    Article  Google Scholar 

  12. von Mikulicz J (1896) Beitrage zur Pathologie und Therapie des Hydrocephalus. Mitteil Grenzgeb Med Chir 1:264–301

    Google Scholar 

  13. Wang JY, Amin AG, Jallo GI, Ahn ES (2014) Ventricular reservoir versus ventriculosubgaleal shunt for posthemorrhagic hydrocephalus in preterm infants: infection risks and ventriculoperitoneal shunt rate. J Neurosurg Pediatr 4:447–454.

    Article  Google Scholar 

  14. Willis BK, Kumar CR, Wylen EL, Nanda A (2005) Ventriculosubgaleal shunts for posthemorrhagic hydrocephalus in premature infants. Pediatr Neurosurg 41:178–185.

    Article  PubMed  Google Scholar 

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Correspondence to Joe Iwanaga.

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Eid, S., Iwanaga, J., Oskouian, R.J. et al. Ventriculosubgaleal shunting—a comprehensive review and over two-decade surgical experience. Childs Nerv Syst 34, 1639–1642 (2018).

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