Role of galeal - Pericranial flap in reducing postoperative CSF leak in patients with intracranial endoscopic procedures

Objective: The authors describe a simple technique to reduce the incidence of cerebrospinal fluid (CSF) leak following endoscopic third ventriculostomy and other neuroendoscopic procedures. Methods: After the scalp incision, the galea and pericranium are reflected in a single layer after the scalp incision which is then closed in a watertight fashion after the procedure is completed. The securely closed flap prevents minor CSF leaks which would have otherwise required intermittent CSF drainage procedures. Conclusion: This simple procedural modification is effective in children with thin cortical mantle and large ventricles who are otherwise highly susceptible for CSF leak in the postoperative period.