Hydrocephalus historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2]

• The historical prespective of hydrocephalus is given below:^[1]
  • Hydrocephalus cases were diagnosed by Hippocrates, Galen and Arabian physicians. They believed that the disease was caused by an extracerebral accumulation of water.
  • Evacuation of superficial intracranial fluid in hydrocephalic children was first described in detail in the 10th century by Abulkassim Al Zahrawi.
  • In 1744, LeCat published findings on a ventricular puncture.
  • In 1881, a few years after the landmark study of Key and Retzius, Wernicke inaugurated sterile ventricular puncture and external cerebrospinal fluid (CSF) drainage.
  • These were followed in 1891 by serial lumbar punctures (Quincke) and, in 1893, by the first permanent ventriculo-subarachnoid-subgaleal shunt (Mikulicz).
  • Ventriculostomy without implants (Anton 1908), with implants, and plexus coagulation initially had a very high operative mortality and were seldom successful in the long term, but gradually improved over the next decades.
  • In 1949, Nulsen and Spitz implanted a shunt successfully into the caval vein with a ball valve.
  • Between 1955 and 1960, four independent groups invented distal slit, proximal slit, and diaphragm valves almost simultaneously.
  • Around 1960, the combined invention of artificial valves and silicone led to a worldwide therapeutic breakthrough.

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