Five-Year Comparative Study of Hydrocephalus in Children With and Without Operation (113 Cases)

Abstract

H YDROCEPHALUS long has been recognized by neurosurgeons as a sign of serious intracranial disease involving obstructions in the pathways of the cerebrospinal fluid. Multiple etiologies of such obstructions have been identified, ~,4,5,16 but some of the major pathophysiologie mechanisms of the cerebrospinal-fluid system in hydrocephalus remain in doubt and under investigation. 19 Progressing hydrocephalus, whatever its cause, produces unequivocal loss of cerebral mass, however, and presumably results thereby in damage to the brain in addition to the damage caused by the process producing the blockage of the cerebrospinal fluid. Neurosurgical operative techniques recently have been developed to such a degree of technical excellence, ~,13-15 however, that progressing hydrocephalus can be arrested by relatively simple surgical techniques, providing adequate postoperative follow-up of such patients is maintained. Thorough study of a significant group of such patients over a long period of time should give some information as to the value of such procedures in preventing brain damage that otherwise might produce an incompetent individual. For reliable conclusions, such a series of surgically treated patients should be compared with a parallel series of patients not operated upon, 2~ especially in regard to functional status of the patients. With this objective in mind, a study has been carried out over a 5-year period in which two groups of patients with hydro-