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Michael Ellis, Merdas Al-Otibi, Peter Bray and Mark Bernstein

The authors describe a simple technique for protecting at-risk scalp overlying CSF shunt hardware. Patients with brain tumors commonly undergo radiation therapy and CSF diversion. Chronic radiation-induced changes in the skin can predispose patients to skin breakdown over the prominent shunt reservoir, which may lead to subsequent contamination of the shunt hardware. The technique described reduces the risk of hardware contamination while obviating the need for revision of the entire shunt system. By reducing the profile of the CSF shunt reservoir, this technique also reduces the risk of future skin ulceration.