CONTINUOUS EXTERNAL SUBDURAL DRAINAGE IN THE MANAGEMENT OF INFANTILE SUBDURAL COLLECTIONS - A PROSPECTIVE-STUDY

Continuous external subdural drainage (CESD) was suggested as a treatm ent step to be inserted prior to SP shunting, primarily because it mak es it possible to avoid shunt placement in a significant number of pat ients. Thirty-three patients with symptomatic chronic subdural collect ion confirmed by computed tomography were included in this study. Unil ateral CESD was performed in all cases, using a lumbar drainage set. T he drains were left in place for no more than 10 days. A subduroperito neal (SP) shunt was inserted in those patients in whom reaccumulation of the subdural collection had occurred. Of 33 patients, 17 were defin itively treated by CESD and 16 subsequently needed an SP shunt. The co st of treatment with CESD was just less than half the cost of treatmen t with SP shunting. CESD can be used as a step before SP shunting in t he management of chronic infantile subdural collections, since it is e ffective without further treatment in half the patients and safer than subdural tapping.