Arrested hydrocephalus and beyond: advances in the pathophysiology, diagnosis, and management of various forms of chronic hydrocephalus: a comprehensive narrative review.

Hydrocephalus results from an imbalance between cerebrospinal fluid (CSF) secretion and absorption. Absence or lack of physiological compensatory mechanisms leads to ventricular dilation and associated clinical symptoms. However, when it is compensated, it is termed as arrested hydrocephalus, which ensures a stable balance between the production and clearance of CSF, that results in normalized intraventricular pressure and minimal ventricular dilatation. Although hydrocephalus can be understood using the traditional bulk flow theory of CSF circulation, arrested hydrocephalus poses unique diagnostic difficulties because of its subtle manifestations and lack of radiographic changes. In this thorough review, the pathogenesis, clinical manifestation, diagnostic standards, and available treatments for various types chronic hydrocephalus, including normal pressure hydrocephalus (NPH) and congenital hydrocephalus, are discussed with emphasis on arrested hydrocephalus.