Adult idiopathic hydrocephalus: current state of the problem

Abstract

The term "idiopathic hydrocephalus" in adults is a broader concept that includes larger spectrum of patients compared to "idiopathic normotensive hydrocephalus". It includes both young and elderly patients with various forms of the disease, patients with various levels of obstruction. Th ere is no general classification and general approach to treat patients with such a pathology. Endoscopic triventriculostomy in idiopathic aqueductal stenosis and cerebrospinal fluid shunting after a positive test of cerebrospinal fluid (tap test) evacuation in idiopathic normotensive hydrocephalus are proved to be effective. In patients with other forms of cerebrospinal fluid pathway obstruction, treatment approach is represented by the opinions of some surgeons. At the same time, most surgeons consider the use of cerebrospinal fluid shunting operations to be effective and justified, and they use endoscopic techniques as an option for examining ventricular system and for performing auxiliary manipulations. The high frequency of various complications of bypass surgery and slightly lower efficiency of endoscopic operations indicates the need to systematize patients; to improve selection criteria and to expand the indications for the use of endoscopic surgical techniques.