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ADELE-Noodles of Neurology > CSF > Flashcards

CSF Flashcards

1
Q

What is the normal volume of CSF per day?

A

500mls

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2
Q

What is CSF produced by?

A

Ependymal cells in the choroid plexus

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3
Q

What is the CSF absorbed by?

A

Arachnoid granulations in the dural venous sinus

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4
Q

Where is the lumbar cistern?

A

Between L2 and S2

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5
Q

What is the normal value for ICP?

A

10mmHg

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6
Q

What level is a lumbar puncture performed?

A

L3/4

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7
Q

What are all the functions of the CSF?

A

Neutral buoyancy
Provides a buffer, absorbing and dissipating the energy
Clearing waste, accommodating to changes in intracranial volume
Provide micronutrients to cerebral tissue e.g. Vit C, Thyroxine

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8
Q

What is the amount of RBCs normally present in the CSF?

A

NO RBCs

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9
Q

The rate of CSF production is dependent on the cerebral perfusion and ICP TRUE/FALSE

A

FALSE

CSF production continues independently of cerebral perfusion and ICP

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10
Q

TRUE/FALSE CSF Production decreases in the elderly

A

TRUE

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11
Q

How does the CSF move from the lateral ventricles to the third ventricle?

A

Foramina of Munro

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12
Q

How does the CSF move from the third ventricle to the fourth ventricle?

A

Through central aqueduct of Sylvia

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13
Q

How does the CSF move from the fourth ventricle to the SAS?

A

Foramina of Luschka and Magendie

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14
Q

Name 6 CSF pathologies

A 
Hydrocephalus
Spontaneous intracranial hypertension
Syringomyelia
Intracranial arachnoid cysts
Dandy walker cysts
Spinal arachnoid webs
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15
Q

What are 4 CNS pathologies?

A

Cerebral oedema
Benign intracranial hypertension
Spinal dural arteriovenous fistulae
Syringomyelia (& Cord Oedema)

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16
Q

What are the 3 reasons that there would be increased CSF?

A

Overproduction at source
Inhibition of reabsorption
Obstruction to the flow of CSF

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17
Q

What would be evident from CSF for narcolepsy?

A

Low or undetectable levels of CSF orexin/hypocretin

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18
Q

What would be the CSF findings if someone has idiopathic intracranial hypertension?

A

High opening pressure

19
Q

What is Xanthochromia present in?

A

Present in the CSF if the patient has Creutzfelt-Jakob syndrome

20
Q

Oligoclonal bands found in the CSF indicate which disease?

A

Multiple Sclerosis

21
Q

Which condition on CSF has an increase in phosphorylated tau protein and decrease in B-amyloid?

A

Alzheimer’s

22
Q

What is hydrocephalus?

A

Accumulation of excessive CSF within the ventricular system of the brain

23
Q

What is a common cause of non-communicating hydrocephalus?

A

Aqueduct stensosi

24
Q

What causes communicating hydrocephalus?

A

When arachnoid granule absorption defects

25
Q

What age does the suture typically close?

A

2-3 years

26
Q

If hydrocephalus occurs before closure of the cranial suture then what occurs?

A

Cranial enlargement

27
Q

If hydrocephalus occurs after the closure of the cranial suture then what occurs?

A

Expansion of ventricles and increase in ICP

28
Q

What causes cerebral atrophy?

A

Dementia

29
Q

Who is central aqueduct stenosis most common in?

A

Children

30
Q

What do these signs point to as a clinical condition?

  • Unusually large head
  • Thin and shiny scalp with easily visible veins
  • Bulging or tense fontanelles
  • Downward looking eyes “sunsetting”
  • Failure to thrive
  • If congenital picked up during an US
A

Hydrocephalus

31
Q

What is the treatment for hydrocephalus?

A

Ventricular Peritoneal Shunt

32
Q

How is the risk of infection reduced when inserting a ventricular peritoneal shunt?

A

Antibiotic or silver impregnated shunts

Use iodine +++

33
Q

What are the 4 steps in the development of normal pressure hydrocephalus?

A

1-Drainage of CSF blocked
2-Collagen disorders
3-Dural Diverticula
4-Trauma

34
Q

Aside from idiopathic what is the other cause of normal pressure hydrocephalus?

A

Post-inflammatory

e.g. SAH,Meningitis, Trauma and craniotomy

35
Q

What is the triad that normal pressure hydrocephalus presents with?

A

Ataxia
Memory decline/reversible dementia
Incontinence

36
Q

What are the 4 causes of spontaneous intracranial hypotension?

A

1-Idiopathic
2-Collagen disorder
3-Dural diverticula
4-Trauma

37
Q

What is Syringomyelia?

A

Cystic enlargement of the spinal cord

38
Q

What is the mean age of presentation fo Syringomyelia?

A

30

39
Q

What is the commonest cause of syringomyelia?

A

Arnold-Chiiari II malformation

40
Q

Expansion of spinal canal interferes with the fibres of the anterior white commissure of spinothalamic tract. Therefore what is affected?

A

Pain, Temperature , Crude Touch

41
Q

Why is hyperhydrosis a feature of early stage syringomyelia?

A

Hyperactivity in pre-ganglionic neurones

42
Q

What is the treatment of syringomyelia if it is caused by chair malformation?

A

Posterior fossa decompression

43
Q

What is the degree of difficult in operating on syringomyelia proportional to?

A

The extent of intramural fibrosis

Collapse of the syrinx cavity

44
Q

Name two conditions where there is Hydrocephalus ex vacuo?

A

Alzheimer’s disease

Picks disease

ADELE-Noodles of Neurology (38 decks)

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