Surgical Treatment of Hydrocephalus: A Historical Perspective

Abstract

Surgical treatment for hydrocephalus has a long and eventful history. This review emphasizes the significant advances made in this century, describing the personalities involved, technical approaches attempted, and materials tested. It concludes by suggesting that better methods of treatment can and should continue to be developed.

Third ventriculostomy for internal hydrocephalus complicated by unrecognized subdural hygroma and hematoma: a case report of a patient treated by Dr. Walter Dandy

“…16,18 Subdural hematomas, which occur occasionally after ventricular shunt placement, rarely occur in association with subdural hygromas. 23,24 In the case under discussion gross examination of the brain at autopsy revealed an obvious relationship between the cyst and the region of the interpeduncular cistern. Microscopic evaluation of this area demonstrated an ependymal-lined outpouching from the floor of the third ventricle, which communicated with the arachnoid and subarachnoid space on the left side.…”

A Case of Recurrent Bacterial Meningitis Due to Retained 54-Year-Old Ureterodural Anastomosis

“…The primary advantage of this shunt type was the hydrodynamic resistance in the ureter was enough to preclude the need for a 1-way valve. 2 Dr Donald Darrow Matson is credited with popularizing lumboureteral shunts 3 - 7 by adapting the ureterodural anastomosis with the introduction of a polyethylene shunt to connect the ureter to the dural sac through the psoas muscle. 3 Dr Matson felt the use of a tube made the procedure easier to complete with fewer complications, as he sought to improve adoption of the procedure.…”

The First Description of a Device for Repeated External Ventricular Drainage in the Treatment of Congenital Hydrocephalus, Invented in 1744 by Claude-Nicolas Le Cat

“…This device, invented by the French anatomist/surgeon Claude-Nicolas Le Cat (1700–1768), has not previously been recognised in the literature, and only few authors have cited this case report from 1744 as the first documentation of ventricular puncture/drainage in the history of treatment of congenital hydrocephalus [5, 6], others only refer to the citations [7, 8, 9]. Most modern reviewers of the history of the (surgical) treatment of hydrocephalus do not mention the published procedure at all [10, 11, 12, 13, 14, 15]. However, in our opinion, Le Cat deserves full credit for the first description of a device for external ventricular tap in a desperate case of congenital hydrocephalus, during which he left a fixed drainage canula in place for 5 days.…”