Background: The treatment of hydrocephalus has evolved over centuries from being an enigma to the use of complex bioprosthetics. Major developments have taken place in the past few decades in shunt hardware and technology, with the use of complex flow regulating valves and biomaterials such as medical-grade silicone having revolutionized the management of hydrocephalus.
Objective: To discuss the evolution of shunts over the decades and how they will evolve in the future.
Material and methods: In this article, we mention an overview of the evolution of shunt technology and hardware from the prehistoric, pre-shunt era to the modern shunt and a brief insight into the future of hydrocephalus treatment. We review the history, development, and pioneers in shunt development and discuss the various types and parts of a shunt system.
Conclusions: Shunts have been developed from the works of Galen and Hippocrates to the latest technologies using in vivo flow biosensors, computational analysis of flow dynamics, and use of artificial intelligence. This has led to an individualized and appropriate management that can be provided to even the most complex cases of hydrocephalus.
Keywords: History of neurosurgery; hydrocephalus; medical-grade silicone; shunt hardware; shunt history; shunt valves; ventricular catheter; ventriculoperitoneal shunt.