Age-related hydrocephalus is a disease of aging, which mainly manifests clinically as intellectual impairment, difficulty in walking and urinary incontinence, and is prone to senile dementia at a later stage. Etiology: (1) direct injury leads to hydrocephalus and brain cell atrophy; (2) hypertension, diabetes and other factors can cause long-term chronic ischemia of cerebral vessels, leading to hydrocephalus and brain cell atrophy; (3) is hydrocephalus mechanical compression of brain cells, cerebral microcirculatory vessels causing insufficient blood supply to the brain, resulting in brain cell atrophy Our brain, cerebellum, spinal cord is immersed in cerebrospinal fluid, cerebrospinal fluid can protect brain tissue in the movement from damage and is a buffering agent. But too much water is not good, because the cranial cavity is a closed container, more water in the brain, more cerebrospinal fluid, the volume occupied by brain tissue becomes smaller, the cerebrospinal fluid will compress the brain tissue, the function of brain cells is affected, there will be slow reaction, walking difficulties, urinary incontinence and other symptoms. At the same time, the cerebral microcirculation vessels are also squeezed, and the blood supply to the brain tissue is affected. As time goes on, the brain tissue gradually turns from simple squeezing to substantial brain cell atrophy caused by long-term poor blood supply, and the brain cells change from reversible to irreversible apoptosis. Clinical manifestations: The earliest manifestation of senile hydrocephalus is mainly mild cognitive impairment: good forgetfulness, less responsive to things than before, and no disease that can explain the cause of these changes can be found in the hospital examination. In fact, this is the beginning of human aging, we should pay attention to. Early symptoms: such as forgetfulness, forgetfulness after doing things, slower dressing than before, inability to remember all the steps of cooking, inability to remember some simple words or replace them with uncommon words when talking with others, making it difficult to understand the words spoken and sentences written; unable to remember where home is at once when going out. The person who used to be diligent slowly becomes bored with household chores and social activities; sometimes he/she gets emotional ups and downs for no reason. Unstable. Even become suspicious, depressed, indifferent, anxious or rude, etc. Mid-term symptoms: (1) The patient’s memory decreases significantly, and the forgetfulness of near matters is especially serious, such as the telephone number of the family, the telephone number of the son and daughter, and the name of the grandchildren. Severe cases also show forgetfulness of distant matters, such as the names of the oldest partner and son and daughter cannot be remembered. Significant cognitive dysfunction appears, and there may also be mental confusion, perceptual difficulties, and decreased general ability; (2) motor dysfunction, unstable walking, unable to take a step as if the foot is sucked by a magnet, difficulty turning around, and unable to walk in a straight line. Some patients who could ride a bicycle or swim could not ride or swim after they got the disease; (3) the ability to calculate and work was significantly reduced, and the comprehension and judgment were also reduced, and they could not perform their work; (4) occasional urinary incontinence appeared. At this stage, the patient needs treatment because the brain cells appear to be out of compensations, and if effective measures are taken, it is possible to save the brain cells that are about to lose their functions. Severe symptoms: The patient is obviously dumb, has obvious difficulty walking, needs assistance, often bedridden or in a chair, loses all kinds of orientation, cannot actively eat, is incontinent, does not know his family, does not even know his own name, is extremely paranoid, has delusions of victimization, hallucinations, etc. Some patients also have inappropriate social behavior. In short, the patient’s intellectual and physical abilities are completely paralyzed, and he or she is unable to take care of himself or herself, and needs special care. Objectively speaking, all patients with dementia have memory loss, but not all patients with memory loss are necessarily demented. This is a normal, physiological change for the elderly. However, some elderly people’s memory does not diminish with age aging, which is obviously related to the degree of education, nutrition, life experience, hobbies, cultural literacy, physical quality, and life scope. Dementia is a disease and memory decline in the elderly is a physiological process; the two have similarities and fundamental differences. Therefore, it can be clearly said that brain atrophy is not Alzheimer’s disease. There are certain similarities between the two, so care should be taken to differentiate them when making a clinical diagnosis. The process of senile hydrocephalus brain atrophy We can determine the recoverability of brain function by means of ancillary tests. However, this is a relatively complex assessment system with many auxiliary examinations and involves the selection of many assessment scales, professional measurements, etc. We at Renji Hospital have integrated the overall strength of neurology and surgery to accomplish this work together. After more than 7 years of special research, we have summarized a set of more standardized diagnostic and therapeutic procedures, which have achieved very good results. Many patients’ own quality of life has been improved, while the nursing workload of family members has been significantly reduced. Treatment: 1. early stage of disease: healthy diet, high quality protein, low fat, etc.; 2. medication: improve vascular elasticity and vascular permeability to improve cerebral microcirculation by activating blood circulation and removing blood stasis; 3. minimally invasive treatment: for some patients, the effect of medication is not obvious, and we find that changes in cerebrospinal fluid circulation can improve the patient’s symptoms through auxiliary examination, we adopt minimally invasive surgery. We adopt minimally invasive surgery to slow down the process of brain atrophy. Minimally invasive surgery: Every surgery has risks, but this surgery is a minimally invasive brain surgery, which is called “ventriculo-abdominal shunt surgery”. The other end is placed into the abdominal cavity, and the entire operation takes one hour. This surgical method is based on the successful development of the extracorporeal precision-regulated shunt tube, which is the only way to demonstrate its efficacy. Because the intracranial cerebrospinal fluid pressure changes in senile hydrocephalus are small and within the normal cranial pressure range, a precision-adjustable shunt control pump is required to achieve therapeutic results with few complications. It has been widely carried out in the United States, Europe and Japan, and in China, we at Renji Hospital, relying on the strong strength and close cooperation of neurological surgery, were the first to standardize this treatment work.