CSF Circulation Disorders Flashcards

1
Q

What is the upper limit of normal of CSF pressure?

A

15mm Hg or 20cm CSF

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2
Q

How much CSF is produced each day?

A

500ml

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3
Q

What drug reduces the production of CSF?

A

Acetazolamide

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4
Q

Where does CSF absorption take place?

A

Arachnoid granulations

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5
Q

Give some functions of CSF

A

Brain buoyancy
Provides nutrition
Clears waste products

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6
Q

Give some signs of hydrocephalus seen at birth

A

Unusually large head
Thin/shiny scalp
Bulging fontanelle
Downward looking eyes

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7
Q

What imaging can be done to look for congenital hydrocephalus?

A

Antenatal ultrasound

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8
Q

What is the main treatment for hydrocephalus?

A

Ventriculoperitoneal shunting

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9
Q

Give some complications of shunting

A

Overdrainage
Underdrainage
Infection
Seizures

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10
Q

Give some symptoms of a blocked shunt

A
Headache and vomiting
Sunset eyes (kids)
No upgaze (adults)
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11
Q

What should be done in the event of a blocked shunt?

A

CT head

Surgery - shunt replacement

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12
Q

What is an alternative treatment to shunting in hydrocephalus?

A

Endoscopic ventriculostomy (ETV)

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13
Q

What is the main advantage of ETV over shunting?

A

Less likely to need replaced

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14
Q

What occurs in normal pressure hydrocephalus?

A

Enlarged cerebral ventricles with normal ICP

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15
Q

What triad of symptoms is seen in normal pressure hydrocephalus?

A

Ataxia (shuffling/broad-based gait)
Memory decline
Incontinence

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16
Q

How is normal pressure hydrocephalus mainly diagnosed?

A

Clincially
CT
Lumbar tap test

17
Q

What treatment options are available for normal pressure hydrocephalus?

A

Lumbar drain

Shunt (mainly VP)

18
Q

Patients with idiopathic intracranial hypertension tend to be obese/underweight and male/female

A

Obese and female

19
Q

What are the main symptoms of IIH?

A

Headaches

Visual loss

20
Q

What is the main sign of IIH?

A

Papilloedema

21
Q

In IIH, CSF pressure is above what?

A

> 25cm CSF

22
Q

What are the main treatments for IIH?

A

Diuretics
LP/VP shunts
Weight loss

23
Q

Give some symptoms of spontaneous intracranial hypotension

A
Orthostatic headaches
Neck/arm pain
Diplopia
Dizziness
Galactorrhoea
24
Q

How is spontaneous intracranial hypertension treated?

A

Conservatively (bed rest/fluids/analgesia)

25
Q

What investigations are done in spontaneous intracranial hypertension?

A

MRI

Lumbar puncture

26
Q

What occurs in syringomyelia?

A

Cyst forms in the spinal cord

27
Q

Syringomyelia commonly occurs in which patients?

A

Spinal trauma patients

28
Q

How does syringomyelia present?

A
Sensory loss
Small muscle wasting
Clawed hands
Loss of upper limb reflexes
Increased lower limb reflexes
29
Q

What is an early stage feature of syringomyelia?

A

Hyperhidrosis

30
Q

What are some common presentations of hindbrain hernias?

A

Headaches following straining/coughing
Visual disturbances
Dizziness
Deafness

31
Q

How is syringomyelia treated?

A

Open up obstructed CSF channels

Drain syrinx cavity

32
Q

What is the main way to open up an obstructed CSF cannel?

A

Craniovertebral decompression