A Review of Endoscopic Treatment of Hydrocephalus in Paediatric and Adult Patients

Endoscopic treatment for hydrocephalus started in the early 20th century, but could not thrive due to poor illumination and magnification of the scope. In the 1950s, ventriculoperitoneal (VP) shunt became widely acceptable as standard treatment for hydrocephalus owing to the invention of well-designed valves and discovery of silicone, a biocompatible material for manufacturing shunt catheters. However, shunting is still far from being an ideal treatment because of its associated complications such as catheter malposition, blockage, and over- or under-drainage of cerebrospinal fluid. The shunt revision rates remained high in recent series. At the same time, endoscopy has undergone tremendous improvement in the latter half of the century and has emerged as an attractive alternative since the early 1990s. The article described the usage of endoscopy in the treatment of hydrocephalus, such as endoscopic third ventriculostomy, fenestration of multi-loculated hydrocephalus, and fenestration of septum pellucidum prior to VP shunting.