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While there’s evidence of hydrocephalus affected skulls found in the ancient world, including in Egypt, Hippocrates (460 BC-370 BC) has been given the credit of being the first to write about it in “De morbis” with the phrase “water over the head” describing an affliction he cured through food, which is pictured above. Celsus (25 BC-50 AD) was the first to use the word hydrocephalus, meaning "collections of humor over the head".[1] Galen (129 AD-216 AD) also described it as a collection of subcutaneous fluid on the head. These were all misinformed attempts at describing hydrocephalus, as it is a build-up of fluid not over the head but within the ventricles.[1]

Source:

1: https://academic.oup.com/brain/article/133/6/1836/350881

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The first description of surgery to evacuate the water in hydocephalic children was by Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi (936-1013 A.D.). He suggested trepanation, and the image shown is a surgical scalpel that would have been used to make an incision and decompress the head of an infant afflicted by hydrocephalus.[1] This is not the only case of trepanation being used to treat infant hydrocephalus- a trephinated skull was found and dated to 2800 B.C. in Iran.[2] Analysis found it was from a girl aged 13-14 and appeared to be hydrocephalic. A triangular hole was found to be carved in the skull along with evidence of bone tissue regeneration, meaning she survived the procedure.[2]

Source:

1: https://link.springer.com/article/10.1007/s00381-008-0773-7

2: https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/106/1/article-p70.xml

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1543: An Accurate Description by Vesalius

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1543: An Accurate Description by Vesalius

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Pictured is a work by Vesalius (1514-1564) entitled "De Humani Corporis Fabrica Libri Septem". Published in 1543, it detailed a case where Vesalius observed a young girl as a patient who appeared to have water collected in her left and right ventricles- overall it was estimated that her brain was holding 9 pounds of water.[1] According to scholars, his observations were the first in 2000 years to lay to rest the misinterpretation of hydrocephalus as fluid collecting outside of the brain.[1] His work would then clear the way for the continued studied of cerebrospinal fluid (CSF).

Source:

1: https://link.springer.com/content/pdf/10.1007/s101430050035.pdf

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Don Filippo de Medici (1577-1582) was born to the Grand Duke and Duchess of Tuscany. He died at just 5 years old due to a combination of rickets, military tuberculosis, and hydrocephalus. When an autopsy was performed after his death, records show that "the equivalent of almost a glass of water" was found under the brain's first membrane.[1] This is a case of non-severe hydrocephalus. Pictured above is a painting of the young boy and his mother next to an x-ray of his skull.[2]

Source:

1: https://www.academia.edu/57427718/Rickets_at_the_Medici_court_of_Florence_the_case_of_don_Filippino_1577_1582_
2: https://www.researchgate.net/figure/a-Portrait-of-Don-Filippino-postmortem-who-died-in-1582-at-age-5-years-and-his_fig3_38114309

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Le Cat's Cure: The First Ventricular Tap

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Le Cat's Cure: The First Ventricular Tap

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The image is of a patient presented to Claude-Nicolas Le Cat (1700-1768) who, in 1744, was the first to be documented attempting a ventricular tap to treat hydrocephalus.[1] For 2 thousand years it was believed that hydrocephalus was fluid outside of the brain, a misconception that was cleared by Vesalius in 1550. Now, this was an attempt to cure it in a way that is similar to it’s modern day treatment. Unfortunately, Le Cat’s newborn patient died after 5 days of enduring the ventricular tap.[1] However, this device that allowed for the external drainage of ventricular CSF was the first of its kind and marked a milestone in the treatment of infant hydrocephalus.[2]

Source:

1: https://link.springer.com/article/10.1007/s101430050035
2: https://www.karger.com/Article/FullText/70872

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Today, hydrocephalus occurs in every one to two per 1,000 babies and has various treatments. One of the most common is a shunt- a long tube with a valve is inserted into the ventricle with the other end tunneling into another bodily area which absorbs the excess fluid. Shunts are typically in place for the entirety of one’s life.[1] However, almost half of all placed shunts fail within one year and 98% within 10.[2] A current advance is being made by researchers at Penn State University who are developing HydroFix- a shunt system that is more advanced than what is currently held as the standard.[2] It works by mimicking the arachnoid villi’s CSF drainage pattern into the sinus system. This technology could revolutionize the way that hydrocephalus is treated and improve the lives of those affected by reducing the amount of surgeries they will undergo in their lifetime, also cutting down the overall cost of their treatments.

Source:

1: https://www.mayoclinic.org/diseases-conditions/hydrocephalus/diagnosis-treatment/drc-20373609
2: https://www.psu.edu/news/impact/story/penn-state-startup-aims-improve-treatment-hydrocephalus/

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Kenneth Blackfan was born in September of 1883 in New York. His impressive career in pediatrics forever changed our understanding of hydrocephalus when he, along with Walter Dandy, discovered the origin of cerebrospinal fluid (CSF) by injecting tracking dye into a dog’s cerebral ventricle.[1] Blackfan also did incredible research on hydrocephalus in which he produced hydrocephalus in dogs, aiding our understanding of its root causes and the role of CSF.[1] He published two papers on internal hydrocephalus in infants. He was also a chairman of Harvard Medical School and would gain international renown as one of the most incredible pediatricians in the country. He performed an immense body of research at Johns Hopkins, which mainly focused on hydrocephalus. His overall impact on pediatric neurosurgery was immense and his untimely death in his early 40's left the pediatric community immensely saddened.

Source:

1: https://link.springer.com/article/10.1007/s00381-015-2658-x