The Cause, Prevention And Management Of Scalp Hydrops After Craniotomy Of Posterior Fossa In Children

Objective: To analyze the causes of scalp hydrops following operation on lesions in posterior fossa and discuss how to prevent and cure it.Methods: The clinical data of 34 children who underwent neurosurgery for posterior fossa lesions in the past 5 years were analyzed retrospectively.Results: Out of 34 posterior fossa operations, 8 scalp hydrops were identified, with an incidence of 23.53%. Higher rates of scalp hydrops were associated with the development of postoperative hydrocephalus (66.67%(4/6) vs 14.29%(4/28)), subtotal resection of the lesions (50.00%(5/10) vs 12.50%(3/24)) and incomplete dural closure (50.00%(6/12) vs 9.09(2/22)). The differences were statistically significant(P<0.05). There was also a trend towards higher occurrence in cases with midline lesions (30.43%(7/23) vs 9.09%(1/11)) and skull defect (36.36(4/11) vs 17.39(4/23)), although the factors examined didn't reach statistical significance. The size of lesions and the use of subdural drainage seem to be not associated with scalp hydrops.Conclusion: Subtotal resection of the lesions, incomplete dural closure and postoperative hydrocephalus are the main reasons of sclap hydrops. Not only a total removal of lesions, a watertight dural closure, a bone flap replacement, but also the prevention and management of postoperative hydrocephalus are the vitalest points to prevent the occurrence of scalp hydrops.