Eid Seif, Iwanaga Joe, Oskouian Rod J, Loukas Marios, Jerry Oakes W, Tubbs R Shane
Department of Anatomical Sciences, St. George's University, St. George's, Grenada.
Seattle Science Foundation, 550 17th Ave, James Tower, Suite 600, Seattle, WA, 98122, USA.
Childs Nerv Syst. 2018 Sep;34(9):1639-1642. doi: 10.1007/s00381-018-3887-6. Epub 2018 Jul 12.
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.
帽状腱膜下间隙是位于帽状腱膜和头皮骨膜之间的纤维蜂窝层。由于其弹性和吸收能力，帽状腱膜下间隙可作为一种分流途径，用于引流脑室中多余的脑脊液。帽状腱膜下分流装置由一根分流管组成，一端置于侧脑室，另一端插入头皮的帽状腱膜下间隙。这将有助于收集和吸收多余的脑脊液。脑室-帽状腱膜下分流术（VSG）的适应症包括急性头部外伤、硬膜下血肿和恶性肿瘤。
VSG分流术对患有出血后脑积水的早产儿特别有利，因为他们无法耐受如脑室-腹腔分流术等长期治疗。并发症包括感染和分流管堵塞。与其他脑积水短期治疗方法相比，VSG在引流多余脑脊液方面具有显著优势。由于脑脊液引流的封闭系统且无外部管道，VSG分流术的感染率低于其他外部脑室引流。
本综述讨论了VSG分流术的优缺点以及我们在该手术中的个人经验。
