Infantile hydrocephalus: clinical, histological, and ultrastructural study of brain damage

✓ Cerebral biopsies were taken from five hydrocephalic infants at the time of primary ventricular shunt insertion. The histological appearance of the biopsies have been correlated with the children's subsequent intellectual and neurological development. In addition, the known sequence of histological events in puppies with experimental hydrocephalus has been correlated with an interpretation of the human material. One child showed periventricular white matter edema and sporadic axonal degeneration characteristic of the acute stage of experimental hydrocephalus in young dogs; this patient developed normally. Biopsies from the other children were not edematous but showed the extensive astrocytosis of white matter seen in long-standing hydrocephalus in young dogs. These children all showed mental retardation. The implications of these clinicopathological results for the treatment of hydrocephalic children are discussed.