Review: treatment of hydrocephalus in adults

Abstract

Hydrocephalus is a major province of neurosurgery because of its high incidence and the still unacceptably high rate of complications that plague all shunting devices (SD). Countless shunts have been designed, some of them rather complex and expensive; however, results continue to be far from satisfactory, indicating that much research is still needed. Hydrocephalus in children is mainly due to congenital abnormalities, whereas hydrocephalus in adults is caused by several different etiopathological conditions; for instance, two frequent forms of primary hydrocephalus in adults are due either to chronic active arachnoiditis or to normotensive hydrocephalus, both of which are almost never seen in children. These two conditions present peculiar challenges for the design of adequate shunting devices. In this review the main aspects of the treatment of hydrocephalus in adults are outlined, stressing principal indications, treatment alternatives, and common complications.