J Korean Neurotraumatol Soc.  2010 Dec;6(2):120-124. 10.13004/jknts.2010.6.2.120.

Subduroperitoneal Shunt for Subdural Hygromas in Adults

• Yoon KS
• Han SR
• Yee GT
• Choi CY
• Sohn MJ
• Lee CH

• KMID: 2106797
• DOI: http://doi.org/10.13004/jknts.2010.6.2.120

Abstract

OBJECTIVE
In symptomatic patients with subdural hygroma, variety of treatment strategies, such as observation, repeated subdural tapping, external subdural drainage, and subduroperitoneal shunt (SPS) have been advocated. Until now, the ideal management for subdural hygromas in adults seems controversial, because of their differences between the effectiveness and the risk of complications. Thus, we evaluated the role of unvalved SPS for subdural hygromas in adults.
METHODS
From January 2001 to December 2007, fifteen patients who had undergone unvalved SPS for symptomatic subdural hygromas in adults at our hospital were retrospectively reviewed. We analyzed the age, gender, initial diagnosis, causes, symptoms, neurological signs, and radiological findings such as thickness of subdural hygroma. Outcome was evaluated according to the post operative Glasgow Outcome Scale (GOS), radiologic findings and complications.
RESULTS
The mean age of the patients is 61 years old (range from 29 to 86). We used the unvalved open-ended catheter to all patients. After SPS, all subdural hygromas disappeared on computed tomography scans within 14 days (mean 6.5 days) except 2 patients. Four patients had GOS 5. GOS 4 was present in three patients. GOS 3 was present in four patients. Three patients had GOS 2. One patient had GOS 1. Complications related to SPS occurred in 5 patients (33%)
CONCLUSION
Our results suggest that unvalved SPS is one of the effective and safe treatment modality for symptomatic subdural hygromas in adults. The overall complication rate is relatively low, including infection and obstructions, compared to previous reports.

Keyword

Subdural hygromas; Subduroperitoneal shunt; Unvalved catheter

MeSH Terms

Adult
Catheters
Drainage
Glasgow Outcome Scale
Humans
Retrospective Studies
Subdural Effusion

Figure

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  FIGURE 1 Serial computed tomography (CT) images of patient number 12. A: Initial CT scan shows hydrocephalus due to cerebellar infarction. B: Bilateral subdural hygroma is noticed on CT image after suboccipital craniectomy. C: Post operative CT image of bilateral subduroperitoneal shunt reveals that subdural hygromas were resolved completely. Arrows indicate bilateral proximal shunt catheters.

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