11. Hydrocephalus Flashcards
What color does calcium, fat, bone, acute bleeding, and air appear on CT scan?
Fat, air = black
Calcium, bone, acute bleeding = white
What cistern houses the circle of Willis?
Supracellar cistern (right above sella turcica)
What fissure separates the temporal lobe from the frontal lobe?
Sylvian fissure
What are the layers of the scalp?
SCALP
Skin, connective tissue, aponeurosis galea, loose CT, periosteum
What is hydrocephalus?
Distended ventricular system due to inadequate passage of CSF from point of production to point of venous absorption
Incidence and epidemiology facts about hydrocephalus
- Most common surgically correctable neurologic problem in peds patients
- Second highest readmission rates
What is an early sign for hydrocephalus?
Dilated temporal lobes
Name three causes of hydrocephalus
Aqueduct stenosis
Myelomeningocoele
Chiari malformation
Communicating vs non-communicating hydrocephalus
Communicating = non-obstructive; hydrocephalus due to excess production > absorption
Non-communicating = intraventricular obstruction
Signs and symptoms of high pressure hydrocephalus
Lethary
N/V
Headache
Signs and symptoms of normal pressure hydrocephalus
Gait apraxia (trouble starting gait)
Dementia
Urinary incontinence
What is the first line diagnosis method?
CT
Current management strategy for hydrocephalus
Surgery = drill hole in skull, insert catheter, remove fluid
Lumbar puncture, shunts, external ventricular drain, third ventriculostomy
What is the only case where you can use lumbar puncture to treat hydrocephalus? What do you have to be careful of during a lumbar puncture?
Communicating hydrocephalus
Make sure there is not a dangerous pressure gradient so that brain doesn’t move toward lower pressure area
What are the current shunts available (4)?
Ventriculo-peritoneal
Ventriculo-atrial
ventriculo-pleural
Lumbar-peritoneal
