CSF pathologies Flashcards

1
Q

Where is CSF produced and absorbed from?

A

Produced from the choroid plexus

Absorbed from the arachnoid granulations

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2
Q

List some examples of CSF pathologies

A

Hydrocephalus

Normal pressure hydrocephalus

Idiopathic intracranial hypertension

Spontaneous intracranial hypotension

Syringomyelia

Cerebral oedema

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3
Q

What are some of the clinical signs and features of hydrocephalus from birth?

A

Large head

Thin and shiny skin on the scalp with visible veins

Bulging fontanelle

“sunsetting”

Poor feeding

Irritability

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4
Q

Shunts can be used in the management of hydrocephalus. Possible complications include blockage and infection. What are some of the signs of blockage?

A

Headache and vomiting

Sunsetting in children, lack of upgaze in adults

Blurred vision (papilloedema)

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5
Q

What are the triad of symptoms which occur with normal pressure hydrocephalus?

A

Urinary incontinence, ataxia and memory loss

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6
Q

Who gets idiopathic intracranial hypertension

A

Young, overweight females

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7
Q

What conditions are associated with idiopathic intracranial hypertension?

A

Sleep apnoea

Hypothyroidism

Addison’s

SLE

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8
Q

What drugs are associated with idiopathic intracranial hypertension

A

Lithium

Steroid withdrawal

Antibiotics

Combined oral contraceptive pill

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9
Q

What are some of the signs and symptoms of idiopathic intracranial hypertension?

A

Horrific headaches

Papilloedema

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10
Q

What is the best form of management for idiopathic intracranial hypertension?

A

WEIGHT LOSS

Diuretics and shunts can also be considered

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11
Q

What is spontaneous intracranial hypotension and what are some of the possible symptoms?

A

rare cause of headaches that results from a CSF leak

Orthostatic headaches

Neck/ interscapular/ arm pain

Diplopia

Muffled hearing

Impaired sphincter control

Galactorrhoea

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12
Q

What are some of the causes of spontaneous intracranial hypotension?

A

Idiopathic

Collagen disorders e.g Marfan’s

Trauma

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13
Q

What is syringomyelia?

A

Cystic enlargement of the spinal cord causing central cord compression

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14
Q

Which spinal cord tracts are affected by syringomyelia?

A

Spinothalamic tract
(loss of pain, pressure, temperature and crude touch)

Corticospinal
(muscle atrophy, weakness and paralysis)

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15
Q

What is the most common cause of syringomyelia?

A

Arnold Chiari II malformation

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16
Q

How does syringomyelia present?

A

loss of pain, pressure, temperature and crude touch

muscle atrophy, weakness and paralysis

loss of upper limb reflexes, increased lower limb reflexes

Hyperhydrosis (excessive sweating)

17
Q

How is syringomyelia investigates and managed?

A

Investigations; MRI

Management; Surgery

18
Q

Hindbrain hernias are associated with which CSF pathology?

A

Syringomyelia

19
Q

What is the difference between communicating and non-communicating hydrocephalus?

A

Communicating hydrocephalus involves no obstruction to flow. The cause is usually reduced CSF absorption.

Non-communicating hydrocephalus is more common and involves obstruction to flow. Causes include tumours.

20
Q

Which brain herniations and supratentorial and which are infratentorial?

A
SUPRATENTORIAL 
Cingulate (subfalcine)
Uncal (transtentorial) 
Central 
Transcalvarial 

INFRATENTORIAL
Tonsillar

21
Q

What is a cingulate herniation?

A

cingulate gyrus displaces under the fall cerebri

22
Q

What is an uncal herniation?

A

The uncal part of the temporal lobe displaces under the cerebellar tentorium

23
Q

What is a central herniation?

A

The diencephalon slips under the tentorium

24
Q

What is a tonsillar herniation?

A

The cerebellar tonsils herniate into the foramen magnum

25
Q

What is a transcalvarial herniation?

A

Brain squeezes out of the skull due to a surgical/ fracture site