Should "normalisation" of the ventricles be the goal of hydrocephalus therapy.

One hundred and nine shunt-treated hydrocephalic children were reviewed. The size of the ventricular system was related to the psychomotor development, recurrent symptomatology and the frequency of shunt complications. Three groups were identified: children with normal functioning shunts, children with a shunt-ASD combination and children whose shunt ceased functioning or had been removed for ten years or more. It is concluded that retarded psychomotor development, recurrent symptoms and ventricular catheter obstructions are more frequent in patients with small ventricles compared to those with residually enlarged ventricles. A "normalised" ventricular system is more likely to be associated with shunt dependency and may, in fact, hinder the ultimate goal of shunt-independence.