Childhood-onset Hydrocephalus

Abstract

Objective: This article highlights important concepts of caring for patients with childhood-onset hydrocephalus across the lifespan, emphasizing recent advances and current areas of controversy.

Latest developments: There are numerous causes of symptomatic hydrocephalus in neonates, infants, and children, and each etiology predicts the typical clinical course across the lifespan. Because the major cellular components essential for CSF dynamics develop predominantly during the third trimester and first 6 months after term birth, directly overlapping with the onset of many types of fetal, neonatal, and infantile hydrocephalus, the timing of onset impacts lifelong management. The treatment of childhood-onset hydrocephalus varies dramatically worldwide due to the differing etiologies and access to neurosurgical interventions. The surgical options for CSF diversion have advanced over the past decade, with a better appreciation of which techniques are more successful for the various types of childhood-onset hydrocephalus. These advances include using temporary shunt devices to delay permanent CSF diversion and endoscopic third ventriculostomy, at times with choroid plexus cauterization.

Essential points: Etiology and age of onset impact the lifelong management of individuals living with childhood-onset hydrocephalus, with a rapid pace of evidence-based changes in clinical practice.