Influence of aetiology in prognosis in surgically treated infatnile hydrocephalus.

Modem surgical treatment of infantile hydrocephalus results in a significantly increased expectaon of life for patients so treated over those in --whom a conservative policy has been adopted. But in order to give as accurate a prognosis as possible, one must inquire whether the results bear any rdation to the aetiology of the condition. One of us (Guthkelch, 1967) has recently described his technique of ventriculo-atrial drainage for this conditon, and assessed the expectation of life, intelligence, and numbers of secondary operations required in an unselected consecutive series of 166 infants so treated. This communication analyses the results in the same series with particular reference to cause. It is conventional to distinguish between the congenital and acquired forms of infantile hydrocephalus. In our series, congenital cases fall into A groups: (1) associated with spina bifida, (2) associated with cranium bifidum, (3) due to aqueduct stenosis occurring otherwise than as part of the Arold Chiari malformation, and (4) consequent upon exit (atresia of the foramen block foramina of Luschka and Magendie). As to the cases in which the hydrocephalus appeared to have been acquired after birth, in some there was a clear antecedent history of bacterial meningits, while the remainder were simply examples of communicating hydrocephalus without any history of infection. The likely aetiological factors in this latter group will be discussed later.