EVOLUTION OF HYDROCEPHALUS TREATMENT: HISTORICAL PERSPECTIVES AND MODERN NEUROSURGICAL STRATEGIES
Keywords:
hydrocephalus, cerebrospinal fluid, ventricular system, ventriculoperitoneal shunt, endoscopic third ventriculostomy, intracranial pressure, neurosurgery, CSF circulation.Abstract
Hydrocephalus is a neurological disorder characterized by abnormal accumulation of cerebrospinal fluid within the ventricular system of the brain, leading to ventricular dilation and increased intracranial pressure. Over the past century, treatment strategies for hydrocephalus have evolved significantly due to advances in neurosurgery, neuroimaging, and biomedical engineering. Early therapeutic approaches were primarily limited to ventricular puncture and external drainage procedures, which were associated with high mortality rates due to infection and insufficient understanding of cerebrospinal fluid physiology. The development of valve-regulated cerebrospinal fluid shunting systems in the mid-twentieth century represented a major breakthrough in the management of hydrocephalus, significantly improving survival and neurological outcomes. More recently, minimally invasive neuroendoscopic techniques such as endoscopic third ventriculostomy have emerged as effective alternatives for selected patients with obstructive hydrocephalus. These procedures allow restoration of physiological cerebrospinal fluid circulation without permanent implanted devices. The present article analyzes the historical evolution of hydrocephalus treatment and evaluates the role of modern neurosurgical technologies in improving clinical outcomes.
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