title: Surgical management of adult hydrocephalus.
abstract: The management of adult hydrocephalus spans a broad range of disorders and ages. Modern management strategies include endoscopic and adjustable cerebrospinal fluid shunt diversionary techniques. The assessment and management of the following clinical conditions are discussed: 1) the adult patient with congenital or childhood-onset hydrocephalus, 2) adult slit ventricle syndrome, 3) multicompartmental hydrocephalus, 4) noncommunicating hydrocephalus, 5) communicating hydrocephalus, 6) normal pressure hydrocephalus, and 7) the shunted patient with headaches. The hydrodynamics of cerebrospinal fluid shunt diversion are discussed in relation to mechanisms of under- and overdrainage conditions. A rationale for the routine implementation of adjustable valves for adult patients with hydrocephalus is provided based on objective clinical and experimental data. For the condition of normal pressure hydrocephalus, recommendations are offered regarding the evaluation, surgical treatment, and postoperative management of this disorder.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of California-Los Angeles, David Geffen School of Medicine, University of California-Los Angeles Medical Center, Los Angeles, California 90095-6901, USA. mbergsneider@mednet.ucla.edu
authors.forename: Marvin
authors.initials: M
authors.lastname: Bergsneider
authors.forename: Chad
authors.initials: C
authors.lastname: Miller
authors.forename: Paul M
authors.initials: PM
authors.lastname: Vespa
authors.forename: Xiao
authors.initials: X
authors.lastname: Hu
mesh_terms: D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects; D020546:Fourth Ventricle / Q000601:surgery; D006261:Headache / Q000209:etiology / Q000628:therapy; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery*; D011182:Postoperative Care