Sir.—In their article "Acute Hydrocephalus in Hurler's Syndrome," Shinnar et al described two patients who were successfully treated by a venticuloperitoneal shunt (Journal 1982; 136:556-557). Although the association of mucopolysaccharidosis (MPS) with hydrocephalus is known, shunt placement has been performed very seldom. Three years ago, we treated a patient with Hunter's syndrome in the same manner with a good result.1
Report of a Case.—A boy suffered from the mild variety of Hunter's syndrome (MPS II-B) associated with moderate mitral regurgitation. His head circumference was always enlarged, but his intellectual development was normal. At the age of 19 years, he was admitted with bacterial endocarditis. During treatment, he complained of persisting headache and blurred vision. A computed tomographic (CT) scan showed severe hydrocephalus with dilation of all ventricles. A scintiscan, after lumbar injection of a tracer dose of technetium diethyltriaminepenta-acetic acid, showed a communicating hydrocephalus characterized by ventricular