Cerebrospinal Fluid - Fremont-Smith Flashcards
central cord
opens superiorly into 4th ventricle
lined with ependymal cells
blood supply to choroid plexus
arterial
lateral and third ventricle - internal carotid and basilar artery
fourth ventricle - posterior inferior cerebellar artery
calcifications of CSF
seen on CT
formation of CSF
choroid plexus - mainly in lateral ventricles
some from ependymal cells - lining ventricles
some from brain substances through perivascular spaces
movement of CSF
pulsation of artery and choroid plexus
aid of cilia and microvilli of ependymal cells
respiration and coughing
changing position
absorption of CSF
dural venous sinuses via subarachnoid granulations
break bridging vessels
subdural hematoma
blood in CSF
subarachnoid bleed
lumbar puncture
blood in CSF - but will go away
traumatic tap
if doesn’t clear - indicates SA bleed
virchow-robbin space
space around vessels - ends at capillaries
- CSF extends to this space
- into brain parenchyma
perivascular space
xanthochromia
blonde colored CSF
- 4-6 hours after SA hemorrhage - oxyhemoglobin
- 2 days after SA hemorrhage - bilirubin
causes of bloody CSF
subarachnoid hemorrhage
intracerebral hemorrhage
cerebral infarct
traumatic spinal tap
neutrophils in virchow robbins space
extends inflammation into the perivascular space into brain parenchyma
leads to edema of brain
brown xanthochromia
seen in meningeal metastatic melanoma
siderphage
hemosiderin macrophage
-in patient with SAH
CSF neutrophilia
bacterial meningitis and other infections
abscess
after seizure, CNS hemorrhage, CNS infarct, repeat lumbar punctures
CSF lymphocytosis
viral meningitis
degenerative disorder
MS, drug abuse, guillan barre
inflammatory disorders
scant blue cytoplasm, fine chromatin, and 1-2 nuclei cells in CSF
with tumor cells
-acute lymphoblastic leukemia
most common metastatic tumor to brain
carcinomas
ex/ breast carcinoma
CSF rhinorrhea
out of nose
-with trauma - fx of skull
beta-2 transferrin
test to determine if CSF
prostaglandin D synthase
aka beta-trace protein - another test for CSF
spontaneous CSF rhinorrhea
with elevated intracranial pressure
manifest in adulthood - with increasing CSF pressure
meningocele
dura herniates
encephalocele
brain parenchyma herniates
double ring sign on filter paper
CSF
localization of CSF leak
intrathecal fluorescein
choroid plexus papilloma
rare
children - lateral ventricle
adult - 4th ventricle
increased CSF production (communicating)
obstruction (obstructive)
both produce hydrocephalus
communicating and non-communicating hydrocephalus
Hydrocephalus may also be communicating or non-communicating. Communicating hydrocephalus occurs when the flow of CSF is blocked after it exits the ventricles. This form is called communicating because the CSF can still flow between the ventricles, which remain open. Non-communicating hydrocephalus — also called “obstructive” hydrocephalus — occurs when the flow of CSF is blocked along one or more of the narrow passages connecting the ventricles.
ependymoma
children and adolescents
mostly in 4th ventricle - cause hydrocephalus - block CSF
most common primary tumor in spinal cord and filum terminale
well demarcated, intra-axial mass - form true rosettes and pseudorosettes**
benign lesion - but location can be problematic
kid playing soccer, loses coordination, has hydrocephalus
ependymoma
tx - shunt
shunts
VP - to peritoneal cavity
VA - to atrium
guillan barre CSF
CSF lymphocytosis
MS CSF
CSF lymphocytosis
choroid plexus carcinoma
rare
