A simple strategy for treating persistent subcutaneous cerebrospinal fluid(CSF) collections following complex neurosurgical procedures

Subcutaneous CSF (CSF "pseudocyst'') may occur following complex skull base operations, They may respond to a trial of compressive bandages and-contin uous lumbar drainage that can resolve over months, When this management str ategy fails, reoperation is an option, which however would require complex reconstructive procedures at the baseof the skull, and still have the chanc e of not resolving the problem. We describe here a simple alternative treatment, consisting of a "pseudocys t"-peritoneal shunting using a flow-regulated unishunt system. This managem ent strategy has been used successfully in two cases showing subcutaneous C SF collections following complex skull base surgery procedures which did no t respond:to a trial of conservative management: A prompt resolution of suc h a complication was achieved In all cases, which persisted during the foll ow-up (7 to 19 months, averaging 12 months). "Pseudocyst"-peritoneal shunti ng using a flow-regulated valve can be a very simple though effective manag ement Option for. persistent CSF subcutaneous collections following major n euro-surgical procedures.