CSF

Question 1

A blockage at the foramen of Monro will cause what?

Answer 1

Hydrocephalus in the lateral ventricles but not in the 3rd and 4th ventricles.

Question 2

A blockage at the cerebral aqueduct (aqueduct of Sylvius–“aqueductal stenosis” or narrowing) will cause what?

Answer 2

Hydrocephalus in the lateral ventricles and third ventricle, but NOT in the fourth ventricle.

Question 3

A blockage at the foramina of Luschka and Magendie (e.g. Dandy-Walker malformation, a genital malformation of the brain in which the cerebellum is lodged in the foramen magnus will cause what?

Answer 3

Hydrocephalus in all four ventricles.

Question 4

A blockage in the arachnoid vili will cause what?

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Answer 4

“Communicating hydrocephalus”–all of the ventricles are in communication with one another, but the CSF is simply not being resorbed back into the venous system.

Question 5

What is “Non-communicating Hydrocephalus”?

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Answer 5

Hydrocephalus that results with no obvious block in the ventricular system. Often caused by bleeding which blocks the resorption of CSF by the arachnoid granulations.

Question 6

Describe the flow of CSF

Answer 6

Cerebrospinal fluid produced by the choroid plexus flows from the lateral ventricles through the foramen of Monro, into the third ventricle, through the Sylvian aqueduct, into the fourth ventricle, out through the foramina of Luschka and Magendie, into the subarachnoid space, and up to the arachnoid granulations to be reabsorbed into the bloodstream

Question 7

Abnormally high levels of RBC’s in the CSF could potentially indicate what?

Answer 7

bleeding into the subarachnoid space

Question 8

Abnormally high levels of just WBC’s in CSF suggests what?

Answer 8

Immune or auto-immune problem

Question 9

Abnormally high levels of protein in the CSF indicates what?

Answer 9

Altered capillary permeability (e.g. inflammation, tumor)

Question 10

Abnormally high levels of immunoglobulin protein in the CSF indicates what?

Answer 10

Presence of plasma cells within the brain, which may indicate infection or an autoimmune disorder

Question 11

Normally, CSF glucose levels are about what fraction of serum levels (except with time delay)

Answer 11

2/3rds

Question 12

Low CSF glucose levels may indicate what?

Answer 12

Possible consumption by microorganisms (e.g. bacterial meningitis)

Question 13

What are 3 mass effect pathologies that can produce an increased cranial pressure?

Answer 13

1. Bleeding
2. Tumor
3. Abscess

Question 14

What are 2 types of Edema that can produce increased cranial pressure?

Answer 14

1. Vasogenic (increased fluid in the extracellular space, such as in inflammation, produce local disruption of the blood brain barrier)
2. Cytotoxic (swelling of neuronal cell bodies, such as in a reaction to ischemia)