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Essentially, this is a condition in which there is ventricular enlargement under tension as a result of an obstruction to the ow of CSF at some point in its ventricular pathway or aqueduct of Sylvius, at the medullary foramens of exit (Luschka and Magendie), or in the basal subarachnoid space Because of the obstruction, CSF accumulates within the ventricles under increasing pressure, enlarging the ventricles and expanding the hemispheres As stated above, in the infant or young child, the head increases in size because the expanding cerebral hemispheres separate the sutures of the cranial bones Regarding terminology, it should be noted that the term hydrocephalus (literally, water brain ) is frequently but incorrectly applied to any enlargement of the ventricles even if consequent to cerebral atrophy, ie, hydrocephalus ex vacuo, or to ventricular enlargement due to failure of development of the brain, a state known as colpencephaly Reference to these conditions as hydrocephalic is so common that it is unlikely to change; hence the authors believe it preferable to use the term tension hydrocephalus for the obstructive types in which the CSF is or has been under increased pressure In 1914, Dandy and Blackfan introduced the also somewhat inaccurate but now well-established terms communicating and noncommunicating (obstructive) hydrocephalus The concept of a communicating hydrocephalus was based on the observations that dye injected into a lateral ventricle would diffuse readily downward into the lumbar subarachnoid space and that air injected into the lumbar subarachnoid space would pass into the ventricular system; in other words, the ventricles were in communication with the spinal subarachnoid space If the lumbar spinal uid remained colorless after the injection of dye, the hydrocephalus was assumed to be obstructive or noncommunicating In actuality, the distinction between these two types is not fundamental, because all forms of tension hydrocephalus are obstructive at some level, and the obstruction is virtually never complete Acute and complete aqueductal occlusion is said to be incompatible with survival for more than a few days The authors suggest that a more appropriate terminology is one in which the site of the presumed obstruction is indicated, eg, meningeal, aqueductal, or third ventricular tension hydrocephalus.

You want to make sure that the mirrored image of the data is kept separate from the primary copy of the data so that a failure of the disk that holds that primary copy will not also affect the mirrored copy To implement this protection, ASM uses the concept of a failure group When you define a disk group, you also define a failure group in relation to that disk group Mirrored data is always placed in a different failure group, which ensures that a mirrored copy of the data is separated from the primary copy of that data If a block fails or is corrupted, ASM will automatically use a mirrored copy of the data without any interruption in service You can direct ASM to actually repair bad blocks from either a command-line interface or Enterprise Manager Normally, a read request will use the primary copy of the data If the read request for that primary copy fails, ASM will automatically read the data from a mirrored copy When a read fails in this way, ASM will also create a new copy of the data, using the mirrored data as the source This approach is automatically used whenever a read request for data is executed and a bad data block is discovered You can force this type of remapping on data that has not been read by means of an ASM command Frequently, disk failures are short-lived, or transient During a transient disk failure, changes can be made to the secondary copy of the data ASM keeps track of these changes, and when the disk comes back online, performs an automatic resynchronization to make the now-available copy of the data the same as the copy of the data that was continually accessible This tracking means the resynchronization process is fast.

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There are several sites of predilection of obstruction to the ow of CSF One foramen of Monro may be blocked by a tumor or by horizontal displacement of central brain structures by a large unilateral mass This causes expansion of one lateral ventricle or a portion of it Large tumors of the third ventricle (eg, colloid cyst) may block both foramina of Monro, leading to dilation of both lateral ventricles The aqueduct of Sylvius, normally narrow to begin with, may be occluded by a number of developmental or acquired lesions with periaqueductal gliosis (genetically determined atresia or forking, ependymitis, hemorrhage, tumor), and lead to

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