Ventriculosubgaleal Shunting for Post-Haemorrhagic Hydrocephalus in Premature Neonates

Abstract

Background: The management of hydrocephalus secondary to intraventricular haemorrhage in neonates can be controversial. Temporary diversion of cerebrospinal fluid (CSF) is often required due to the low birth weight and high risks of shunting in these patients. Ventriculosubgaleal (VSG) CSF diversion is an effective way of achieving this goal whilst minimising the risks of complications. It is a well-described technique but is rarely used in contemporary neurosurgical practice. Methods: Nine neonates treated with VSG shunting for post-haemorrhagic hydrocephalus were assessed. Gestational age, birth weight, duration of treatment efficacy, requirement for permanent shunting and complications were recorded. Results: In all 9 patients, the VSG shunt controlled the progression of hydrocephalus. A permanent shunt was avoided in 2 patients. One patient required revision of the subgaleal shunt to extend the interval to the insertion of a permanent shunt. None of the patients developed any CSF infection or leak. Conclusion: VSG CSF diversion offers a simple, effective and relatively safe means of treating hydrocephalus in the neonate, with a low risk of complications and the possibility of avoiding permanent shunting.