Paediatric hydrocephalus

Paediatric hydrocephalus is the commonest disorder to be managed by paediatric neurosurgeons. Rather than representing a single disease process, hydrocephalus can result from a variety of different pathological processes or insults that culminate in an imbalance of cerebrospinal fluid (CSF) production and absorption. If left untreated, the majority of cases are fatal, but with appropriate surgical management most patients survive, with some leading normal lives into adulthood. The mainstay of treatment is with CSF shunts, but with technological improvements in imaging and surgical techniques an increasing number are being successfully treated with neuroendoscopic procedures. The disorder can be complex to manage, with many patients requiring multiple surgical procedures and lifelong follow-up. This chapter gives an overview of paediatric hydrocephalus, its causes and classification, management with shunts and endoscopy, description of surgical techniques, and the outcomes of surgical care.