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Classification of Hydrocephalus

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Pediatric Hydrocephalus

Abstract

The contemporary classification of hydrocephalus has resulted from clinical and basic science research using new technology and scientific endeavors. The classification is based on the assumption that all hydrocephalus results from a restriction of flow from the point of production of cerebrospinal fluid (CSF) within the cerebral ventricles and its point of absorption eventually into the systemic circulation. The point of restriction model was the subject of debate among a group of experts in the field of basic science and clinical care.

The CSF system can be seen as a hydraulic circuit with specific points of restriction of flow. The identified points of restriction are the foramina of Monro, the aqueduct of Sylvius, the exit foramina of the fourth ventricle, passage of CSF from the spinal to cortical subarachnoid space, the final pathway of CSF absorption, and when the skull is distensible the venous outflow of the dural venous sinuses. It is of note that venous hypertension can only lead to hydrocephalus if the cranium is distensible.

Each of these points of flow restriction is caused by a limited number of pathologies. Recognizing these points of flow restriction can lead to a variety of treatment options. One specific outcome related to the case of what has been called “communicating” hydrocephalus. In reality this form of hydrocephalus rarely results from a problem of terminal absorptive restriction but from a restriction of flow between the spinal subarachnoid and cortical subarachnoid spaces. In this situation, the patient may be an excellent candidate for endoscopic third ventriculostomy.

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Author information

Authors and Affiliations

  1. Neurosurgery, Donald and Barbara Zucker Hofstra Northwell School of Medicine, Hempstead, NY, USA

    Harold L. Rekate

Authors
  1. Harold L. Rekate
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Corresponding author

Correspondence to Harold L. Rekate .

Editor information

Editors and Affiliations

  1. Pediatric Neurosurgery, Santobono Pausilipon Children’s Hospital, Naples, Italy

    Giuseppe Cinalli

  2. Division of Pediatric Neurosurgery, Acıbadem University, School of Medicine, Istanbul, Istanbul, Turkey

    M. Memet Ozek

  3. Hopital Necker-Enfants Malades, Paris, France

    Christian Sainte-Rose

Appendix

Appendix

Members of committee to produce a consensus on the definition and classification of hydrocephalus (Rekate 2008)

Osamu Sato

MD

Tokyo, Japan

Shizuo Oi

MD, PhD

Tokyo, Japan

Charles Teo

MD

Sydney, Australia

John Pickard

MD

Cambridge, UK

Marion Walker

MD

Salt Lake City, UT

J. Patrick McAllister

PhD

St. Louis, MO

Gordon McComb

MD

Los Angeles, CA

Martina Messing-Yünger

MD

Sankt Augustin, Germany

Michael Pollay

MD

Sun City West, AZ

Spyros Sgouros

MD

Athens, Greece

Petra Klinge

MD, PhD

Providence, RI

Thomas Brinker

MD, PhD

Providence, RI

Conrad Johansson

PhD

Providence, RI

Concezio Di Rocco

MD

Rome, Italy

Harold L Rekate

MD

Great Neck, NY

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Rekate, H.L. (2018). Classification of Hydrocephalus. In: Cinalli, G., Ozek, M., Sainte-Rose, C. (eds) Pediatric Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-319-31889-9_45-1

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  • DOI: https://doi.org/10.1007/978-3-319-31889-9_45-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31889-9

  • Online ISBN: 978-3-319-31889-9

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