Hydrocephalus: past, present and future

Till forty years ago infants and children with hydrocephalus had a bleak future. Most of them used to die. Those who survived lived with mental retardation, spasticity and blindness. With the advent of an effective shunting device in 1957, a new era was ushered in the history of hydrocephalus. Today an infant with hydrocephalus has a good chance of symptom-free survival into adulthood. This landmark achievement divides the past from the present. Although CSF shunts bring about a dramatic improvement in symptoms, the long term results reveal a high incidence of shunt related problems and therefore, the search for a competent and long lasting surgical treatment continues. The purpose of this communication is to review the contributions of the past, to critically evaluate the achievements of the present and to predict the advances expected to come through in the future.