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.
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Clinical outcome of subdural versus subgaleal drain after burr-hole drainage for chronic subdural hematoma.
Acta Neurochir (Wien)
November 2024
Department of Neurosurgery, Utrecht University Medical Center, Utrecht, Netherlands.
Article Synopsis
- Chronic subdural hematoma (CSDH) treatment often involves burr-hole drainage and either subdural or subgaleal drain insertion, with surgeon preference influencing the choice.
- A study analyzed 700 CSDH cases from 2017 to 2022, finding no significant differences in recurrence, reoperation rates, or complications between subdural and subgaleal drains.
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Subgaleal hemorrhage in neonates: a comprehensive review and summary recommendations.
J Perinatol
September 2024
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Subgaleal hemorrhages (SH) involve bleeding in the expansive compartment between the periosteum of the skull and the galea aponeurotica. The potentially rapid accumulation of blood in this space is responsible for the clinical severity, as neonates with SH can present with acute hypovolemia, shock and multiorgan failure. SH is associated with instrumented delivery, especially with use of vacuum extraction.
View Article and Find Full Text PDFSubgaleal drain versus dissection of subgaleal space and closure without drain after burr-hole drainage of chronic subdural hematoma.
Surg Neurol Int
August 2024
Department of Neurosurgery, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt.
Background: Chronic subdural hematoma (CSDH) is a collection of blood, blood degradation products, and fluid that accumulate on the surface of the brain between its arachnoid and dural coverings. This study is to evaluate the efficacy of subgaleal drain (SGD) versus subgaleal dissection without drainage as adjuncts to burr-hole evacuation of CSDH.
Methods: A retrospective study was conducted utilizing the data of 60 patients operated for symptomatic CSDH.
Subgaleal Collection: An Unusual Presentation of a Scalp Mass in a Pediatric Patient.
Cureus
June 2024
Department of Radiology, Texas Tech University Health Sciences Center, Lubbock, USA.
Subgaleal fluid collection is a rare phenomenon of scalp swelling among young infants and, in many cases, adolescents. As fluid accumulates in the subgaleal space, it presents as a soft, ill-defined, fluctuant, mobile swelling not limited to suture lines. This condition is associated with vacuum-assisted devices and forceps during delivery in infancy.
View Article and Find Full Text PDFComparison between the use of subdural and subgaleal drainage in treatment of chronic subdural hematoma.
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Servicio Neurocirugía, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Background And Objectives: Chronic subdural hematoma (CSDH) is one of the most common pathologies in our daily practice. The standard treatment is the evacuation making a burr-hole and placement of a subdural drainage, which has shown to decrease its recurrence. However, this procedure can entail risks such as parenchymal damage, infection, or the onset of seizures, prompting the consideration of subgaleal drainage as an alternative.
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