The Natural History of Hydrocephalus

Abstract

A series of 182 unselected and unoperated cases of hydrocephalus, observed by one individual during a period of 20 years, were followed in an effort to determine the natural history of hydrocephalus. At the time of this report, 89 of the patients had died and 81 arrested spontaneously and the remaining 12 were either progressive or could not be traced. In most cases the hydrocephalus was acquired either through infection or perinatal trauma and anoxia. The children were all under the age of 13 years and hydrocephalus was first observed to develop usually by 6 months of age. The survivors with arrested hydrocephalus frequently had other physical handicaps in addition to the enlargement of the head. The intelligence of the survivors was tested and 75% of those with spontaneous arrest were educable and the I.Q. of 57% was 85 or above. The author points out that the findings in this survey are in contrast to the statements generally made in the literature: that the possibility of spontaneous arrest and preservation of a degree of intelligence permitting education is extremely poor. The bearing of the findings on the evaluation of the results of surgical therapy are discussed.