Hydrocephalus is a condition where cerebrospinal fluid (CSF) accumulates in the brain due to a mismatch between the rate of its formation and its reabsorption back into the blood. As this fluid accumulates, pressure within the brain increases, resulting in rapid growth of the head in infants or signs of increasing brain dysfunction in older children and adults.
Prior to the advent of computerized axial tomography (CAT scans), the prognosis for children with hydrocephalus was generally poor. It was believed that an abbreviated life span would be plagued by numerous shunt revisions and associated complications. There was little optimism concerning physical and intellectual well-being over the course of a lifetime; patients, families and physicians were exasperated by the many problems associated with the equipment available to manage the condition.
The CAT scan has changed this situation enormously. Most patients and families can now look forward to the likelihood of normal longevity with little or no intellectual or physical impairment. To ensure this, however, the neurosurgeon must be highly experienced in treating hydrocephalus and must keep continually informed of advances in the understanding the condition and its treatment.
The following discussion will center on innovations in the treatment of hydrocephalus, and the problems that must be considered by the treating physicians, families and the community.