Building on previous National Institutes of Health-sponsored symposia on
hydrocephalus research, "Opportunities for
Hydrocephalus Research: Pathways to Better Outcomes" was held in Seattle, Washington, July 9-11, 2012. Plenary sessions were organized into four major themes, each with two subtopics: Causes of
Hydrocephalus (Genetics and Pathophysiological Modifications); Diagnosis of
Hydrocephalus (
Biomarkers and Neuroimaging); Treatment of
Hydrocephalus (Bioengineering Advances and Surgical Treatments); and Outcome in
Hydrocephalus (Neuropsychological and Neurological). International experts gave plenary talks, and extensive group discussions were held for each of the major themes. The conference emphasized patient-centered care and translational research, with the main objective to arrive at a consensus on priorities in
hydrocephalus that have the potential to impact patient care in the next 5 years. The current state of
hydrocephalus research and treatment was presented, and the following priorities for research were recommended for each theme. 1) Causes of
Hydrocephalus-CSF absorption, production, and related
drug therapies; pathogenesis of human
hydrocephalus; improved animal and in vitro models of
hydrocephalus; developmental and macromolecular transport mechanisms; biomechanical changes in
hydrocephalus; and age-dependent mechanisms in the development of
hydrocephalus. 2) Diagnosis of
Hydrocephalus-implementation of a standardized set of protocols and a shared repository of technical information; prospective studies of multimodal techniques including MRI and CSF
biomarkers to test potential pharmacological treatments; and quantitative and cost-effective CSF assessment techniques. 3) Treatment of
Hydrocephalus-improved bioengineering efforts to reduce proximal
catheter and overall shunt failure; external or implantable diagnostics and support for the
biological infrastructure research that informs these efforts; and evidence-based surgical standardization with longitudinal metrics to validate or refute implemented practices, procedures, or tests. 4) Outcome in
Hydrocephalus-development of specific, reliable batteries with metrics focused on the hydrocephalic patient; measurements of neurocognitive outcome and quality-of-life measures that are adaptable, trackable across the growth spectrum, and applicable cross-culturally; development of comparison metrics against normal aging and sensitive screening tools to diagnose idiopathic
normal pressure hydrocephalus against appropriate normative age-based data; better understanding of the incidence and prevalence of
hydrocephalus within both pediatric and adult populations; and comparisons of aging patterns in adults with
hydrocephalus against normal aging patterns.