Nonobstructive Hydrocephalus

A sound rationale for the treatment of nonobstructive (communicating) hydrocephalus by extirpation of the choroid plexuses from the cerebral ventricles was first advanced by Dandy¹in 1918. The original operative technic proposed by Dandy to accomplish this end was essentially an "open" operation, in the sense that the cerebrospinal fluid was first evacuated from the two lateral ventricles, after which surgical extirpation of the two choroid plexuses was performed in a dry field under direct vision (fig. 2 A) This procedure was simple and direct, but Dandy¹stated that in cases of hydrocephalus of certain degree... "death will follow almost immediately upon the release of fluid.... In the advanced cases we can hold out very little encouragement from operative procedures of any kind which will necessitate release of fluid and collapse of the brain. In three [of four] cases of this series... there was an immediate operative collapse