Management of hydrocephalus around the world.

OBJECTIVE: The objective of this study is to review the management of hydrocephalus and, in particular, how different economic and social conditions affect its treatment around the world. METHODS: The main techniques for the surgical treatment and the management of hydrocephalus have been retraced through a brief historical overview up to the present day. RESULTS: During the last century, continuous technological progress has favored the diffusion of expensive and sophisticated shunt systems. On the other hand, the advent of minimally invasive endoscopic techniques, such as endoscopic third ventriculostomy, seems to represent a valid route for attempting a natural cerebrospinal fluid diversion, thus avoiding complications related to shunt failure. CONCLUSIONS: The management of hydrocephalus around the world is still widely debated. However, definition of proper indications and adequate training in neuroendoscopic techniques seem to represent the preeminent trend for new generations of neurosurgeons.