obstructive hydrocephalus

Hi. My husband had a cerebrovascular accident at 10 days old in 1965.  A shunt was put in.  There have never been any revisions.  He has obstructive hydrocephalus.  He has a 19mm x 17mm cavernous angioma in his fourth ventricle and an arachnoid cyst mildly deviating the brainstem to the right.  He has a third ventriculostomy in December of 2005.  After surgery he could not walk and had a hard time speaking.  He can now walk, but falls and is unsteady.  His speech is sometimes confusing to understand.  He needs to rest alot.  When he is upright for to long he says he feels like he has "cobwebs" in his head.  His last CT said that he has focal encephalomalacia of the left frontal lobe.  What does this mean?  The scan also says there is marked dilation of the ventricles.  He is 42 years old.  He does not want to go through another surgery.  What can be expected  to progress with this type of condition in the future?  Thank you>