Adult patients with "asymptomatic" and "compensated" hydrocephalus benefitfrom surgery

Objectives - 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 d escribes the results of CSF diversion in these patients. Material and metho ds - 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 si gns of motor or psychometric impairment, had indications of an infantile or childhood debut, and had previously been ignored. In 15 patients the ventr icular enlargement was a coincidental finding. Seventeen patients underwent shunt surgery or endoscopic third ventriculostomy. Results - All but one o perated upon improved. Six patients declined surgery, but have been followe d with 1 showing deterioration, the remaining being unchanged. Conclusion - In addition to patients with "symptomatic congenital" most adult "asymptom atic" and "arrested"/"compensated" hydrocephalus patients can benefit from surgery despite a considerable duration of disease.