Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
World Neurosurg. 2024 Mar;183:113-122. doi: 10.1016/j.wneu.2023.12.094. Epub 2023 Dec 22.
Chronic hydrocephalus in adults (CHiA) includes all nonacute forms of hydrocephalus occurring in adulthood. It covers a spectrum of disorders. Some of these have relatively agreed on definitions, while others are less well characterized. The existing medical classification systems lack adequate structure and are neither clinically oriented nor easy to use, which severely hampers research and clinical care efforts.
A systematic literature review and data analysis were performed, focusing on the terms "adult hydrocephalus" and "classification," using the PubMed, Scopus, and Cochrane Library databases. Data on terminology, definitions, patient demographics, symptom duration, and clinical presentations were extracted, analyzed, and compiled. A Delphi process was followed to define CHiA disorders.
A total of 33 studies collectively used 48 terms to define various CHiA disorders. Different terms were used to describe similar conditions. CHiA disorders were found to be clustered into 7 distinctive clinical entities based on the clinical characteristics.
An evidence-based new clinical classification for CHiA is suggested. Our review identified gaps in knowledge and areas for further research.
成人慢性脑积水（CHiA）包括成年人发生的所有非急性脑积水形式。它涵盖了一系列疾病。其中一些疾病有相对明确的定义，而另一些则特征不明显。现有的医学分类系统缺乏足够的结构，既不面向临床，也不容易使用，严重阻碍了研究和临床护理工作。
使用 PubMed、Scopus 和 Cochrane Library 数据库，针对“成人脑积水”和“分类”这两个术语进行了系统的文献回顾和数据分析。提取、分析和汇总了有关术语、定义、患者人口统计学、症状持续时间和临床表现的数据。随后进行了德尔菲法以定义 CHiA 疾病。
共有 33 项研究共使用了 48 个术语来定义各种 CHiA 疾病。类似的疾病使用了不同的术语来描述。根据临床特征，CHiA 疾病被分为 7 种不同的临床实体。
建议建立一种基于循证的成人慢性脑积水新的临床分类。我们的综述发现了知识空白和进一步研究的领域。
