[Torkildsen's operation--50 years later].

Arne Torkildsen performed the first ventriculocisternostomy in 1937. During the last 25 years hydrocephalic patients have been treated with standard ventriculoatrial or ventriculoperitoneal shunts. Since pneumoencephalography and ventriculography, have been replaced by CT scanning, often no differentiation is made between communicating and non-communicating hydrocephalus. Today we realize that most shunted individuals become shunt-dependent for the rest of their lives. During a two year period we performed eight ventriculocisternostomies after aqueduct obstruction had been proven by ventriculography or by combined CT and magnetic resonance studies. In five of the patients this gave a satisfactory long term result. Since this procedure does not lead to serious cardiopulmonary complications nor overdrainage, the Torkildsen procedure is still a good alternative to ventriculoperitoneal or ventriculoatrial shunts in patients with proven non-communicating hydrocephalus.