Pathogenesis disruption of fluid flow from the brain-based research institute the National Institute of Neurological Disorders and Stroke (NINDS), the United States, there are three types, namely a first flow restriction circulatory disorders, brain tumor samples contained in the ventricles will obstruct the flow of cerebrospinal fluid . Second, the flow of cerebrospinal fluid is not blocked, otherwise it produced excessive fluid, resulting in increased cerebrospinal fluid, eg, malignant tumors in cells that produce cerebrospinal fluid.
Then, the third, when the amount of brain fluid flowing normally and there is no obstruction, but there is an interruption in the process of absorption of fluid into the vein. So automatic, the amount of fluid will also rise. For example, if there is fluid or pus (meningitis or infection of the lining of the brain) or blood (due to trauma) in the vicinity of absorption.
Imbalance between the production and absorption, can slow or progressive, causing the ventricles are dilated, and then pressing the brain tissue surrounding. Skull bones in babies under two years are not yet closed will allow the enlarged head
Enlargement of the head is one of the important clinical clues to detect hydrocephalus. According to researchers Milrohat TH (1982), Paine RS (1967), and Brett EM (1983), efforts to head circumference measurements in serial and regularly is very important in early detection of this disease.
The development of a normal head circumference in newborns is 2 cm per month for first 3 months, 1 cm per month for 3 months the second, and 0.5 cm per month for the next 6 months. Nellhaus in 1968 created a head circumference percentile charts are still used today.
Other clinical manifestations include large fontanel is the baby will be widened and prominent blood vessels in the scalp and more clearly, the sensory-motor disturbances, visual impairment (blind), move the affected eye (squint), there was a progressive decline in mental activity, fussy baby, cramps, vomiting, fever are difficult to control, and finally disruption of vital functions due to elevated pressure within the space of the skull that slow breathing, pulse rate decreased and increased systolic blood pressure
To support and complement the diagnosis, additional examinations required ranging from simple, like plain photos head and followed with ultrasonography. Sonography examination with a minimum of data to assess ventricular dilation and the thickness of brain tissue. If the thickness is less than 2 cm, the surgery is considered not useful anymore.
While imaging is able to see the detail space skull and brain tissue, was selected computerized tomography scan examination (CT scan) or magnetic resonance imaging (MRI) because it can detect brain anatomical structures, and cause of hydrocephalus, such as tumors in the ventricular cavity are all related to the strategy hydrocephalus treatment
hydrocephalus treatment is life saving and life sustaining "which means that this disease requires early diagnosis followed by immediate surgical action. The delay will cause disability and death of patients. Action in hydrocephalus surgery actually has pioneered since several centuries ago by Ferguson in the year 1898 be made shunt or a shortcut to drain cerebrospinal fluid in the skull of a clogged space to another place using a small diameter catheter similar devices.
Mechanical method is expanding, like Matson (1951) created a shortcut from the ventricular cavity to the urinary tract (ureters ventrikulo), Ransohoff (1954) developed a shortcut from the ventricular cavity into the chest cavity (pleural-ventrikulo). Furthermore, Holter (1952), Scott (1955), and Anthony J Raimondi (1972) introduced a shortcut to the living heart of Atria (ventrikulo-atrial) and the abdominal cavity (ventrikulo-peritoneal) that the flow direction by using a safety valve.
Technology continues to grow with the shortcuts found inert materials such as silicon which was previously used polyethylene materials. That is important because the hoses were planted in shortcuts of the brain tissue, skin, and abdominal cavity in a long time even for life, so patients need to avoid rejection by the body's reaction effects. Shortcut hose products are now becoming more sophisticated, there are examples which are equipped with adjustable pressure valve so that the flow of brain fluid, there is also coated with antibacterial substances and there is a mixture of special material so that the hose is more durable, flexible, and not easily broken.
Surgery performed after the installation of shortcuts hose equipped diagnosis and indications as well as the requirements are met. Actions performed on patients who have been drugged total, there are a small incision in the head area and conducted the opening of the skull and the lining of the brain which then hose shortcut ventricle in pairs, followed and then made a small incision in the abdomen, abdominal cavity was opened and then planted the abdominal cavity between the hose shortcuts both ends of the hoses were connected to a hose shortcut planted under the skin so that is not visible from the outside.
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