الفهرس 
Anatomy of the hydrocephalousOnly 14 pages are availabe for public view
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Abstract
Hydrocephalus is an imbalance of C.S.F formation and absorption of sufficient magnitude to produce a net accumulation of C.S.F.within the cerebral ventricles. This excess in fluid usually causes increase in the intracranial pressure.
Hypothetically, the condition may arise in three ways:
-Obstruction of CSF pathways
-CSF over secretion
-Impaired venous drainage
In patients with an incurable cause of hydrocephalus, CSF diversionary procedureto a structure or area where it can be absorbed or excretedshould be performed.
Three different shunt systems were commonly used for diversion of CSF: ventriculatrial (VA), venticuloperitoneal (VP) and lumboperitoneal (LP).
It is apparent that CT scanning is the diagnostic procedure of choice for evaluating patients with known or suspected hydrocephalus.Also,cranial sonography is a very good diagnostic tool, especially in cases with opened anterior fontanelle.
Hydrocephalus should be treated if it is progressive even if it is asymptomatic, and it should be treated if it is symptomatic, even if the symptoms are subtle or atypical. Treatment is contraindicated if hydrocephalus is asymptomatic and non progressive.
Treatment of hydrocephalus can be done by different methods either medical, surgical or endoscopic. In general, medical therapy of hydrocephalus is far inferior to surgical management and it can be used to delay surgical intervention or as a pre-operative procedure.
Recent studies show that VP shunting has become the initial procedure of choice when treating hydrocephalus, particularly in the neonate.
Ventriculoperitoneal shunts are presently the mainstay of hydrocephalus treatment because of their ease of insertion and reliable long-term function. Other types of extracranial shunts as ventriculoatrial,ventriculopleural and lumboperitoneal shunts are usually reserved for circumstances in which ventriculoperitoneal shunts are contraindicated.
Despite the proven effectiveness of ventriculoperitoneal shunts in treating hydrocephalus, complications continue to occur with distressing frequency.
Complications of surgery include shunt infection, septicemia (after ventriculoatrial shunt), adhesions and paralytic ileus, migration, peritonitis, and intestinal perforation (with peritoneal shunt).
This clearly means that the shunt systems and the techniques in current use involve many problems that have yet to be solved.
Endoscopic management of hydrocephalus can be done by different techniques such as endoscopic septostomy,cyst fenestration, choroid plexus coagulation and endoscopic third ventriculostomy.
Endoscopic thid ventriculostomy is a procedure in which a tiny perforation is made in the floor of the third ventricle,thus allowing movement of the cerebrospinal fluid out of the blocked ventricle into the subarachnoid space.Because of high rate of shunt malfunction and the severity of some complications in cases of aqueduct stenosis,endoscopic third ventriculostomy must be considered as an alternative treatment for these patients but as the first choice at least in a selected group.
Endoscopic third ventriculostomy is a simple,safe,and effective treatment option for selected forms of hydrocephalus.
Endoscopic third ventriculostomy decreases the number of hospital days and emergency visits for shunt failure.
The success rate of Endoscopic third ventriculostomy could be dependent on many factors such as age of the patient, cause of hydrocephalus, indications, choice of individual neurosurgeons, duration of follow-up,and possibly the technique used.