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History

In 1881, Carl Wernicke pioneered sterile ventricular puncture and external drainage of CSF for the treatment of hydrocephalus. This occurred a few years after the landmark study of Retzius and Key. In 1891, Heinrich Quincke first described using a lumbar puncture to drain excess spinal fluid. This eventually led to investigating permanent treatment methods. This would require developing a continuous drain to treat hydrocephalus. In 1893, Jan MIkulicz-Radecki used a permanent shunt to drain CSF successfully. It wasn't until the 20th century that hydrocephalus remained an intractable condition. This was when cerebral shunt and other neurosurgical treatment modalities were developed. In the early 20th century, the role of the arachnoid villi in absorbing cerebrospinal fluid was confirmed by Harvey Cushing. He recommended draining the fluid into the retroperitoneal space rather than the scalp. He was the first to attempt to create a shunt to the external jugular vein using a transplanted vein from the patient's father. In the 1950s, the invention of radiotracers allowed for scientists to trace the flow of cerebrospinal fluid. These findings were critical for shaping future therapies and treatments of hydrocephalus.