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Hydrocephalus is not a specific disease; rather, it represents a diverse group of conditions that result from impaired circulation and absorption of CSF or, in the rare circumstance, from increased production by a choroid plexus papilloma Hydrochepalus adalah penyakit yang tidak spesifik yang disebabkan oleh kerusakan sirkulasi dan absorpsi CSF atau pada keadaan yang cukup langka, dari peningkatan produksi choroid plexus papilloma. The CSF is formed primarily in the ventricular system by the c
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  Hydrocephalus is not a specific disease; rather, it represents a diverse group of conditions that result from impaired circulation and absorption of CSF or, in the rare circumstance, from increased production by a choroid plexus papilloma Hydrochepalus adalah penyakit yang tidak spesifik yang disebabkan oleh kerusakan sirkulasi dan absorpsi CSF atau pada keadaan yang cukup langka, dari peningkatan produksi choroid plexus papilloma. The CSF is formed primarily in the ventricular system by the choroid plexus, which is situated in the lateral, 3rd, and 4th ventricles. Although most CSF is produced in the lateral ventricles, ≈25% srcinates from extrachoroidal sources, including the capillary endothelium within the  brain parenchyma. There is active neurogenic control of CSF formation as adrenergic and cholinergic nerves innervate the choroid plexus. Stimulation of the adrenergic system diminishes CSF production, whereas excitation of the cholinergic nerves may double the normal CSF  production rate. In a normal child, ≈20 mL/hr of CSF is produced. The total volume of CSF approximates 50 mL in an infant and 150 mL in an adult. Most of the CSF is extraventricular. The choroid plexus forms CSF in several stages; through a series of intricate steps, a plasma ultrafiltrate is ultimately processed into a secretion, the CSF. CSF diproduksi di system ventricular oleh choroid plexus yang terletak di ventrikel lateral, ventrikel ke-3 dan ventrikel ke-4 dengan proses ultrafiltrasi dan menghasilkan sekresi. Walaupun sebagian besar CSF diproduksi di ventrikel lateral, 25% berasal dari sumber extrachoroidal, termasuk endotel kapiler didalam parenkim otak. Ada control neurogenic aktif dalam formasi CSF karena adanya nervus adrenergic dan kolinergik yang menginervasi choroid plexus. Stimulasi adrenergic menurunkan produksi CSF, sedangkan eksitasi nervus kolinergik akan melipatgandakan produksi CSF. Produksi CSF normal pada anak ≈20 mL/hr  . total volume CSF  pada bayi 50 mL in an infant and 150 mL pada dewasa. CSF flow results from the pressure gradient that exists between the ventricular system and venous channels. Intraventricular pressure may be as high as 180 mm H 2 O in the normal state, whereas the pressure in the superior sagittal sinus is in the range of 90 mm H 2 O. Normally, CSF flows from the lateral ventricles through the foramina of Monro into the 3rd ventricle. It then traverses the narrow aqueduct of Sylvius, which is ≈3 mm long and 2 mm in diameter in a child, to enter the 4th ventricle. The CSF exits the 4th ventricle through the paired lateral foramina of Luschka and the midline foramen of Magendie into the cisterns at the base of the brain. Hydrocephalus resulting from obstruction within the ventricular system is called obstructive  or noncommunicating   hydrocephalus.  The CSF circulates from the basal cisterns posteriorly through the cistern system and over the convexities of the cerebral hemispheres. CSF is absorbed  primarily by the arachnoid villi through tight junctions of their endothelium by the pressure forces that were noted earlier. CSF is absorbed to a much lesser extent by the lymphatic channels directed to the paranasal sinuses, along nerve root sleeves, and by the choroid plexus itself. Hydrocephalus resulting from obliteration of the subarachnoid cisterns or malfunction of the arachnoid villi is called nonobstructive  or communicating hydrocephalus. Aliran CSF berasal dari gradient tekanan antara system ventrikel dan venous channels. Intraventrikular pressure mungkin mencapai 180 mm H 2 O dalam keadaan normal, sedangkan tekanan pada superior sagittal sinus sekitar 90 mm H 2 O. pada keadaan normal csf mengalir dari  ventrikel lateral melalui foramen monro ke ventrikel ke-3 lalu ditransver melalui aqueduct kecil yang disebut dengan Sylvius (dengan panjang 3mm dan diameter 2mm pada anak-anak dan masuk ke ventrikel ke 4. Hydrocephalus yang disebabkan oleh obstruksi dalam system ventrikel disebut Obstructive atau noncommunicating hydrocephalus. PATHOPHYSIOLOGY AND ETIOLOGY.  
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