Once the diagnosis of hydrocephalus has been established, the choice of treatment is involved. Hydrocephalus is the simplest and most easily treated disease. However, it is also the most complex and difficult to treat. Simply put, either type of hydrocephalus can be treated with a shunt procedure, but there are some inherent disadvantages to shunt surgery. First, carrying a shunt inside your body for the rest of your life is a very difficult thing to accept. There is also a risk of infection while the shunt is in the body, and in most cases the shunt will need to be removed if it becomes infected, otherwise the infection will be difficult to cure. This can be very costly to the patient and delayed for a long time. Shunt obstruction, fracture, aging, etc., all need to be replaced. A high percentage of patients with shunts that have been in place for too long can develop lacunar ventricular syndrome, where the patient has high intracranial pressure, symptoms such as intermittent headaches, and even cognitive impairment. The best option available to address such problems is the placement of an adjustable pressure shunt. The third ventriculostomy is the best solution for hydrocephalus, with the advantage that it does not require carrying a shunt. It is important to note that a large proportion of shunts done early (usually about 10 years) are part of obstructive hydrocephalus. Once the shunt becomes problematic, the first thing to consider is whether a fistula can be done, and if the fistula is feasible, the shunt can be removed. There is also a part of hydrocephalus that is very difficult to deal with, called clinically refractory hydrocephalus, which requires long-term comprehensive treatment, and even then a good outcome is not always possible.