CSF drainage strategy and complication management of hydrocephalus

Background and objectives: Conventional CSF drainage strategies-using external ventricular drainage (EVD) for acute hydrocephalus and permanent shunts (ventriculoperitoneal [VP], ventriculoatrial [VA], lumboperitoneal [LP]) for chronic hydrocephalus-are often inadequate in complex clinical scenarios (e.g., patients with intracranial hemorrhage, active infection, or unstable conditions who cannot undergo permanent shunt surgery). This creates an urgent need to comprehensively review drainage modalities to address the core challenge of reducing surgical frequency while effectively controlling intracranial pressure (ICP) and avoiding complications.