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Child's Nervous System

, Volume 28, Issue 3, pp 357–362 | Cite as

Multiloculated hydrocephalus: a review of current problems in classification and treatment

  • Morten AndresenEmail author
  • Marianne Juhler
Review Paper

Abstract

Purpose

Loculated hydrocephalus is a condition in which discrete fluid-filled compartments form in or in relation to the ventricular system of the brain. Both uni- and multiloculated variants exist, with marked differences in outcome. However, several competing and seemingly interchangeable nomenclatures exist, and none address the pathophysiological basis of the condition. To clarify current treatment options, we carried out a review of the literature.

Methods

A protocol describing search strategy and inclusion criteria was prepared in advance, and a search of MEDLINE, the Cochrane Database of Systematic Reviews, and the U.S. NIH ClinicalTrials.gov database was carried out with the search terms: “multicystic,” “multiloculated,” “multicompartment,” “uniloculated,” and “loculated.” All were used in conjunction with the search term “hydrocephalus.”

Results

A single study with a control group was found. Remaining reports are purely case series. Research efforts are hampered by unclear and seemingly interchangeable nomenclatures, which makes comparison between studies difficult. There is a paucity of studies of high methodological quality concerning choice of treatment. At the case series level, evidence is in favor of the neuroendoscopic approach.

Conclusions

In order to ensure a consistent nomenclature as well as to guide future research, we propose a new system of classification for loculated hydrocephalus. It acknowledges the differences between uniloculated and multiloculated hydrocephalus, and goes beyond a pure anatomical model. For future research, it enables us to clearly characterize subgroups, which is essential if we are to advance our understanding and level of care for this challenging group of patients.

Keywords

Hydrocephalus Multiloculated Multicompartment Multicystic Complex hydrocephalus Classification 

Notes

Acknowledgments

The authors received research grants from The Aase og Ejnar Danielsen Fund, The Augustinus Fund, and Dagmar Marshalls Fund. We are grateful for their help and their support of this study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Clinic of Neurosurgery, NK2092Copenhagen University HospitalCopenhagen ØDenmark

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