CSF Circulation Disorders Flashcards
What is the upper limit of normal of CSF pressure?
15mm Hg or 20cm CSF
How much CSF is produced each day?
500ml
What drug reduces the production of CSF?
Acetazolamide
Where does CSF absorption take place?
Arachnoid granulations
Give some functions of CSF
Brain buoyancy
Provides nutrition
Clears waste products
Give some signs of hydrocephalus seen at birth
Unusually large head
Thin/shiny scalp
Bulging fontanelle
Downward looking eyes
What imaging can be done to look for congenital hydrocephalus?
Antenatal ultrasound
What is the main treatment for hydrocephalus?
Ventriculoperitoneal shunting
Give some complications of shunting
Overdrainage
Underdrainage
Infection
Seizures
Give some symptoms of a blocked shunt
Headache and vomiting Sunset eyes (kids) No upgaze (adults)
What should be done in the event of a blocked shunt?
CT head
Surgery - shunt replacement
What is an alternative treatment to shunting in hydrocephalus?
Endoscopic ventriculostomy (ETV)
What is the main advantage of ETV over shunting?
Less likely to need replaced
What occurs in normal pressure hydrocephalus?
Enlarged cerebral ventricles with normal ICP
What triad of symptoms is seen in normal pressure hydrocephalus?
Ataxia (shuffling/broad-based gait)
Memory decline
Incontinence
How is normal pressure hydrocephalus mainly diagnosed?
Clincially
CT
Lumbar tap test
What treatment options are available for normal pressure hydrocephalus?
Lumbar drain
Shunt (mainly VP)
Patients with idiopathic intracranial hypertension tend to be obese/underweight and male/female
Obese and female
What are the main symptoms of IIH?
Headaches
Visual loss
What is the main sign of IIH?
Papilloedema
In IIH, CSF pressure is above what?
> 25cm CSF
What are the main treatments for IIH?
Diuretics
LP/VP shunts
Weight loss
Give some symptoms of spontaneous intracranial hypotension
Orthostatic headaches Neck/arm pain Diplopia Dizziness Galactorrhoea
How is spontaneous intracranial hypertension treated?
Conservatively (bed rest/fluids/analgesia)
What investigations are done in spontaneous intracranial hypertension?
MRI
Lumbar puncture
What occurs in syringomyelia?
Cyst forms in the spinal cord
Syringomyelia commonly occurs in which patients?
Spinal trauma patients
How does syringomyelia present?
Sensory loss Small muscle wasting Clawed hands Loss of upper limb reflexes Increased lower limb reflexes
What is an early stage feature of syringomyelia?
Hyperhidrosis
What are some common presentations of hindbrain hernias?
Headaches following straining/coughing
Visual disturbances
Dizziness
Deafness
How is syringomyelia treated?
Open up obstructed CSF channels
Drain syrinx cavity
What is the main way to open up an obstructed CSF cannel?
Craniovertebral decompression
