Adult patients with “asymptomatic” and “compensated” hydrocephalus benefit from surgery

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Abstract
There exists no consensus regarding the appropriate treatment of the group of adult hydrocephalus patients often denoted as "arrested"/ "compensated", "asymptomatic" or "symptomatic congenital". Our case series describes the results of CSF diversion in these patients. During the period of 1984 to 1994, 23 consecutive adult patients with "asymptomatic" (n = 10), "compensated" (n = 7) and "symptomatic congenital" (n = 6) hydrocephalus were prospectively evaluated. All patients showed signs of motor or psychometric impairment, had indications of an infantile or childhood debut, and had previously been ignored. In 15 patients the ventricular enlargement was a coincidental finding. Seventeen patients underwent shunt surgery or endoscopic third ventriculostomy. All but one operated upon improved. Six patients declined surgery, but have been followed with 1 showing deterioration, the remaining being unchanged. In addition to patients with "symptomatic congenital" most adult "asymptomatic" and "arrested"/"compensated" hydrocephalus patients can benefit from surgery despite a considerable duration of disease.