1500 Years of Hydrocephalus Treatment—How Little It Has Changed

Abstract

ydrocephalus is an ancient disease from both an archeological perspective and written history. In H reviewing our surgical treatment of hydrocephalus, where there has been at least some modicum of surgical success, we can only go back 100 years to the end of the 19th century. An early invasive treatment (albeit temporary) was introduced by Heinrich I. Quincke (1842e1922) in which he introduced the spinal puncture and serial spinal taps for removal of spinal fluid (4). The spinal tap was introduced in the 1890s both for diagnostic examination of the spinal fluid and also for removal of spinal fluid in hydrocephalus. Other inventive individuals attempted cerebrospinal fluid (CSF) drainage/diversion by putting in tubes through the vertebral body and draining the fluid into the peritoneum. Neurosurgeons really did not have any successful forms of surgical treatment for hydrocephalus until the 1950s, when some inventive people such as John W. Holter, Robert H. Pudenz, Frank E. Nulsen, and Eugene B. Spitz, among others, came up with CSF diversion systems allowing the CSF to be diverted from the cerebral ventricles to the heart or abdomen using a recently introduced tubing material made of silicone. To put this all into perspective, the generation practicing neurosurgery now has in 1 generation been able to come up with some reasonably good surgical solutions for the surgical treatment of hydrocephalus.