Primary congenital hydrocephalus. Long-term results of controlled therapeutic trial.

Holter's invention of the non-retum valve and its use in ventriculo-caval drainage operations has been a revolutionary step in the treatment of hydrocephalus. The valves effectively control intracranial pressure and prevent the back flow of blood from the vascular system. This technique has been in use in this country since January 1958. In our unit 48 such operations were carried out during 1958, using the Holter valve. Having acquired technical experience and confidence in the operation, we decided to assess its value and limitations, and to define the indications for and the timing of this procedure by fully controlled therapeutic trials. In this paper we describe one such trial, in which all the patients suffered from uncomplicated congenital hydrocephalus. The second trial covering the treatment of congenital hydrocephalus in infants who were born with meningomyelocele will be described in a separate publication.