Adult hydrocephalus: advancements in diagnosis, treatment, and patient outcomes

Abstract

Hydrocephalus in adults comprises a diverse grouping of etiologies, pathophysiology, diagnostic criteria, and treatment needs. Furthermore, hydrocephalus is more common in adults than in children,1 and surgical procedures for hydrocephalus in adults in the US are annually performed almost five times more frequently compared with pediatric patients.2 A previously described pragmatic, clinically oriented organizational scheme helps to ensure we distinguish four types of patients within the spectrum of adult hydrocephalus: 1) transitional patients (previously diagnosed with hydrocephalus and treated as children), 2) patients with previously unrecognized congenital hydrocephalus, 3) patients with acquired hydrocephalus with an identifiable etiology (e.g., subarachnoid hemorrhage, cerebral trauma, or infection), and 4) patients with suspected or proven idiopathic normal pressure hydrocephalus. 3 There are distinct differences in these four patient groupings regarding diagnostic, treatment, and outcome issues