CSF and Hydrocephalus

Question 1

What is another name for the Foramina of Lushka?

What is another name for the Foramen of Magendie?

What structure do these foramen connect to allow for CSF flow?

Answer 1

Lateral Apeture

Medial Apetrue

4th ventricle to the Subarachnoid space

Question 2

Which of the following foramen connects the Lateral ventricles to the 3rd venricle?

A. Foramen of Lushka

B. Foramen of Magendie

C. Interventricular Foramen of Monro

D. Cerebral Aqueduct of Sylvius

Answer 2

Interventricular Foramen of Monro

Question 3

What is the difference between communicating and non communicating Hydrocephalus?

What are the 2 types of communicating hydrocephalus?

Answer 3

Communicating Hydrocephalus means there’s no obstruction of flow, while non-communicating means it’s obstructive

Overproduction of CSF (rare)

Under-absorption of CSF

Question 4

What type of Hydrocephalus does this patient have?

Answer 4

Aqueductal Stenosis

• non-communicating (obstructive)
• accumulation of CSF in lateral and 3rd ventricle , because the cerebral aquaduct is closed off
• note the smaller 4th ventricle and enlarged lateral and 3rd ventricles

Question 5

What does the patient have?

Answer 5

Normal Pressure Hydrocephalus

• form of communicating hydrocephalus, as CSF just fails to drain properly
• notice the enlarged lateral ventricles

Question 6

What are the BIG 3, the TRIAD, of symptoms associated with Normal Pressure Hydrocephalus?

Answer 6

Cognitive Impairment/Confusion

Ataxic Gait

Urinary Incontinence

Normal Pressure Hydrocephalus= CGU

Question 7

What does this patient have?

Answer 7

Dandy-Walker Malformation

• notice the enlarged lateral and 4th ventricle
• non-communicating hydrocephalus
• 4th ventricle outlet is obstructed, and this causes the cerebellum not to form properly

Question 8

What does this patient have?

Answer 8

Chiari II

• downward displacement of the inferior cerebellar vermis and tonsils through the foramen magnum
• non-communicating hydrocephalus where fluid accumulates above the 4th ventricle

Question 9

What conginital abnormalitly is often associated with Chiari II?

Answer 9

Lumbrosacral Myelomeningocele (spina bifida)

Question 10

If all of the ventricles are enlarged, as a general rule unless theres an obstruction past the 4th ventricle, what sort of issue should you assume?

Answer 10

There is an absorption issue

Question 11

What are the 4 functions of CSF?

Answer 11

Shock-absorption

Buoyancy

Metabloic: moving of metabolites away from the brain (unidirectional flow)

Endocrine: moving hormones around the brain

Question 12

What are some of the causes of aqueductal stenosis?

Answer 12

Tumor pressing on the aqueduct

Congenitally narrow aqueduct

Gliosis

Question 13

List the ventricles and foramen in order of the flow of CSF.

Answer 13

Lateral Ventricle > Foramen of Monro > 3rd VEntricle > Cerebral Aqueduct > 4th Ventricle > Lateral Foramina of Luschka and Medial Foramina of Magendie > Subarachnoid Space

Note: CSF also goes from the 4th Ventricle into the Central Canal of the Spinal Cord