A subdural tap is a medical procedure that removes excess fluid build-up in the subdural space, a condition caused by an illness or substantial head trauma. The operation may be conducted on babies by putting a small hollow needle via the fontanelle or the suture.
A fontanelle (fontanel) is a soft area between an infant's skull's five primary bones (2 frontal bones, 2 parietal bones, and an occipital bone). These bones are joined together by a soft membrane known as a suture. Sutures enable the bones to shift to suit the skull's expansion.
A subdural tap was traditionally used as a diagnostic technique to discover the source of an acute or chronic buildup of subdural fluids that resulted in an increase in intracranial pressure. It might also be used to remove an abnormally large volume of fluid, such as cerebral spinal fluid (CSF) and/or blood.
Computed tomography (CT) scans are now commonly accessible. Because the treatment is non-invasive, it has become the method of choice for identifying disorders that cause high intracranial pressure. However, if a CT scan is not available or the patient cannot be brought in for a CT scan, a subdural tap may be required.
How is the Procedure Carried Out?
Unless a subdural tap is being done as an emergency procedure, the attending physician will inform the parent/guardian of the reason for the procedure, how it will be conducted, what will happen during the process, and any risks or problems that may occur during and after the treatment.
In most circumstances, neither general nor local anaesthetic will be required for the newborn. However, sedatives or pain relievers may be required to assist relax the patient. A subdural tap is normally planned two to three hours after eating. This drastically minimises the chances of nausea or vomiting during the surgery.
A CT scan, MRI, or ultrasound may be necessary before the surgery to assist the doctor in locating or identifying the precise location where a subdural tap is required. A CT scan is a precise tool for finding excess fluid buildup. However, imaging tests may not be conducted if these technologies are not accessible or if the patient's existing state precludes him or her from being transferred.
The doctor will shave the region of the head where the surgery will take place initially. This not only makes it simpler for the doctor to pinpoint the precise region and execute the treatment, but it also reduces the possibility of infection.
. The doctor will next inject a needle into the suture or fontanelle to collect fluid samples from the region. The needle will then be removed by the doctor, and the entrance site may need to be closed with a single stitch.
Potential Risks and Complications
A subdural tap may be risk-free, however, there are dangers and problems. For example, there is a chance that the needle may be put too deeply, causing injury to the underlying cortex.
Complications that may arise include bleeding caused by minor blood vessel injury, infection, and the creation of a fistula (abnormal channel) as a result of several subdural taps.
It is quite probable that the treatment will need to be done on a regular basis, possibly daily or every other day. Every time the surgery is done, the risks and problems remain the same.