Post-infection and multiloculated hydrocephalus (Complex Hydrocephalus)

Abstract

Multiloculated hydrocephalus is one of the most challenging disorders in neurosurgery. Until now, there is no known curative treatment and the disease is considered to be a progressive condition. It results as a complication of other neural pathological disorders which involve the ventricular system and produce inflammation such as meningitis, intraventricular hemorrhage, and shunt infection which accounts for most of the cases. Historically and until the present time, the only definitive treatment for multiloculated hydrocephalus is surgical. However, despite all these treatments, the septations of the ventricles continue to proliferate leading to accumulation of CSF in the isolated compartment with compression of the surrounding neural tissues. Early diagnosis and treatment is the single most important factor that leads to better outcome and prognosis. However, prevention of the formation of multiloculated hydrocephalus by avoiding its causes and early diagnosis is very crucial to deal with such a serious disease. The precise incidence of multiloculated hydrocephalus (complex hydrocephalus) is not known. Currently, the surgical method of choice is neuroendoscopic with navigation fenestration of the multiloculated cysts to create connection and smooth CSF flow inside each ventricle, to allow insertion of one shunt. So far, there is no clear understanding of the formation of the septum and the pathological stages of its development. This chapter includes results of our research study to elaborate on and explain the stages of the histopathological development of the septum in correlation with CT scan findings.