Received: December 05, 2009
Accepted: January 03, 2010
Ref: Eghwrudjakpor PO, Allison AB. Evolution of surgical interventions for hydrocephalus: patient preferences and the need for proper information. Internet J Med Update 2010 Jul;5(2):55-62.
EVOLUTION OF SURGICAL INTERVENTIONS FOR HYDROCEPHALUS: PATIENT PREFERENCES AND THE NEED FOR PROPER INFORMATION
Dr. P. O. Eghwrudjakpor MBBS, DMS, FICS and Dr. A. B. Allison MBBS, FRCS, FICS
Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
(Corresponding Author: Dr. P. O. Eghwrudjakpor, Departments of Surgery, University of Port Harcourt Teaching Hospital, PMB 6173, Port Harcourt, Nigeria; Email: firstname.lastname@example.org)
The treatment of hydrocephalus has undergone remarkable transformation since it was first documented over two thousand years ago. Currently, the focus of hydrocephalus research is on minimally invasive techniques of treatment. This article reviews the evolution of hydrocephalus therapy, and examines current attitudes towards modern methods. We relied on journal publications, as well as literature on hydrocephalus obtained from the Internet (Google, Yahoo and PUBMED search) making use of the following search terms: “hydrocephalus: history; treatment; complications”, “cerebrospinal fluid shunt”, “endoscopic third ventriculostomy: indications of; complications of; advantages; disadvantages; successes; failure”. Numerous medical and surgical approaches have been adopted in the treatment of hydrocephalus in the past. However, the breakthrough that ushered in the modern era of hydrocephalus treatment was the introduction of valve-regulated systems in the middle of the last century. Endoscopic third ventriculostomy has evolved to become an alternative to traditional shunts. Cerebrospinal fluid shunt procedures are very effective in the treatment of hydrocephalus and have radically transformed the outcome of the disorder. However, they have a number of limitations. The alternative to shunts, endoscopic third ventriculostomy, is relatively safe, effective and durable. It does not, however, succeed in every patient; and also has some potentially devastating complications. Preoperative counseling is imperative to ensure that patients are properly guided.
KEY WORDS: Cerebrospinal fluid shunt; Complications; Endoscopic third ventriculostomy; Hydrocephalus; Indications; Patient selection