Needle biopsies of the cerebral mantle were taken from 12 hydrocephalic children aged between 14 days and 3 years. 5 children were biopsied twice or more often during subsequent shunting operations. Histological studies of biopsies embedded in epoxy resin for light and electron microscope examination revealed more useful information than those embedded in paraffin wax. There was evidence of axonal degeneration in the white matter of patients with acute hydrocephalus. Progressive gliosis was seen in more chronic hydrocephalus together with signs of cerebral atrophy. No measurable effect of hydrocephalus on myelination was detected. This histological study of needle biopsies taken at shunt operations could be useful in assessing brain damage and thus in predicting future intellectual development in hydrocephalic children.
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