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Updated: Aug 24, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Complications of ventriculosubgaleal shunts in infants and children
R Shane Tubbs1, Jason T Banks, Scott Soleau
1Department of Cell Biology, University of Alabama at Birmingham, Birmingham, AL 35233, USA. richard.tubbs@ccc.uab.edu
Insights
Ventriculosubgaleal shunts offer temporary cerebrospinal fluid (CSF) bypass, with complications like infection and leakage being manageable. This method provides significant benefits for select pediatric neurosurgical patients.
Area of Science:
- Neurosurgery
- Pediatric Neurology
Background:
- Ventriculosubgaleal shunts are used for temporary cerebrospinal fluid (CSF) bypass.
- A comprehensive review of complications associated with this procedure is lacking in current literature.
Purpose of the Study:
- To retrospectively analyze the complications of ventriculosubgaleal shunting.
- To evaluate the safety and efficacy of this technique in a pediatric population.
Main Methods:
- Retrospective review of 170 ventriculosubgaleal shunts placed over six years.
- Documentation of all complications, including infection, hemorrhage, and wound leakage.
- Analysis of patient demographics, including premature infants with intraventricular hemorrhage and hydrocephalus, and other specific pediatric conditions.
Main Results:
- Infection rate: 5.9%
- Intracranial hemorrhage rate: 1.1%
- Wound leakage rate: 4.7%
Conclusions:
- The benefits of ventriculosubgaleal shunting outweigh the risks for select pediatric patients.
- Complication rates are comparable to other neurosurgical CSF diversion techniques.
- This procedure eases the burden of care for children requiring temporary CSF management.
Introduction:
The ventriculosubgaleal shunt has been used for the temporary bypass of the normal cerebrospinal fluid (CSF) pathways. To date, a large series of complications from this procedure has not been elaborated upon in the literature.
Patients And Methods:
We retrospectively reviewed all such shunts (170) placed at our institution over the last 6 years and documented all complications from this procedure. The majority of patients operated upon were premature infants with intraventricular hemorrhage and subsequent hydrocephalus. This technique was used in a much smaller group of patients in whom the peritoneal cavities were not currently candidates for distal shunt implantation but would have been with time. Other patients in whom this technique was used were those with malignant brain tumors, intraventricular abscesses, chronic truncal wounds, chronic subdural hygromas, and meningitis.
Results:
Complications from subgaleal shunting included infection (5.9%), intracranial hemorrhage (1.1%), and wound leakage (4.7%).
Conclusions:
We believe the benefits afforded by ventriculosubgaleal shunting significantly outweigh the risks of the procedure and greatly ease the burden of care for this select population of children. Based on the literature and our own experience, the complications from this procedure are not excessive or extraordinarily unique compared with other neurosurgical CSF diversion techniques.
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