["Compensated hydrocephalus" (author's transl)].

Abstract

Out of 60 consective cases with hydrocephalus of pediatric age group, 8 cases were found to be so-called "compensated" hydrocephalus and their clinical features were reported. "Compensation" of hydrocephalus in our cases was probably induced by increased ventricular absorption of cerebrospinal fluid since moderate to severe ventricular dilatation was present in all cases. Such "compensation" of hydrocephalus is apparently made at the expense of normal development of the brain function. Therefore, such "compensation" of hydrocephalus is not the condition to be aimed for, but to be avoided for preservation of normal brain function. In order to prevent such "compensation" of hydrocephalus, shunt function should be followed carefully especially in those whose initial shunts were placed at older age, and in whom symptoms of increased intracranial pressure were not so apparent before the initial shunt-placement. Further treatment for hydrocephalus was considered to be necessary in our cases since unrolling of the anterior cerebral artery was invariably present. Unrolling of the anterior cerebral artery was found even in such cases whose cerebrospinal fluid pressure was normal, head circumference did not show any increase, and IQ test was normal. In one case, "compensated" hydrocephalus became later "decompensated" with apparent signs of increased intracranial pressure. Other supplementary tests for cerebrospinal fluid dynamic such as saline infusion test or RISA cisternography were also discussed.