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Neurology SOH > Disorders of CSF circulation > Flashcards

Disorders of CSF circulation Flashcards

1
Q

Where is CSF formed?

A

In the choroid plexus of the ventricles

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2
Q

CSF is continuously produced. True or false?

A

True

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3
Q

CSF production rates increase in the elderly. True or false?

A

False

- decrease

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4
Q

What drug reduces the production of CSF?

A

Acetazolamide

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5
Q

What are the functions of CSF

A

Buoyancy
Provides micronutrients to cerebral tissue
Accommodates physiological changes in vascular volumes in the head by being displaced into the spinal canal

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6
Q

Why do we get rising ICP

A

If the brain enlarges, some blood must escape from the cranial vault to avoid the rise in pressure. Once this process is exhausted, the venous sinuses are flattened and there is little or no CSF

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7
Q

Causes of raised ICP

A

Hydrocephalus
Space occupying lesion
Oedema

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8
Q

Hydrocephalus - definition

A

Accumulation of excessive CSF within the ventricular system of the brain resulting in increased ICP.

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9
Q

What are the 2 classifications of hydrocephalus

A

Communicating

Non-communicating

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10
Q

Communicating hydrocephalus

A

Obstruction to flow of CSF outside of the ventricular system
- eg in subarachnoid space or arachnoid granulations

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11
Q

Non-communicating hydrocephalus

A

Obstruction to flow of CSF occurs within the ventricular system so CSF is incapable of exiting the ventricular system

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12
Q

Hydrocephalus - pathophysiology

A

Obstruction to flow of CSF
Over-production of CSF
Decreased absorption of CSF

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13
Q

Cranial enlargement occurs if hydrocephalus is present BEFORE/AFTER the closure of cranial sutures ?

A

Before

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14
Q

Expansion of the ventricles and increase in ICP occurs if hydrocephalus is present BEFORE/AFTER the closure of cranial sutures ?

A

After

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15
Q

Hydrocephalus - clinical features (congenital)

A 
Unusually large head 
Thin, shiny scalp 
Bulging/tense fontanelle 
Downward looking eyes (sunsetting) 
Poor feeding 
Vomiting 
Sleepiness
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16
Q

Hydrocephalus - what are the 2 management options

A

Surgical shunt

Endoscopic ventriculostomy

17
Q

Hydrocephalus - surgical shunt

A

Shunt is implanted in the brain ventricles allowing excess CSF in the brain to flow to a different part of the body

18
Q

Complications of surgical shunts

A

Over drainage
Under drainage
Blocked shunt
Infection

19
Q

Hydrocephalus - endoscopic ventriculostomy

A

Make a hole in the floor of the brain to allow trapped CSF to escape to the brain surface where it can be absorbed

20
Q

Normal pressure hydrocephalus - definition

A

Enlarged cerebral ventricles but other areas are normal

Normal ICP

21
Q

Normal pressure hydrocephalus is most common in which age group?

A

Elderly

22
Q

Normal pressure hydrocephalus - clinical features

A

Ataxia
Memory decline
Incontinence

23
Q

Idiopathic intracranial hypertension - who gets it

A

Obese

Young females

24
Q

Idiopathic intracranial hypertension - clinical features

A

Headaches

Visual losses

25
Q

Idiopathic intracranial hypertension - clinical signs

A

Papilloedema
Constriction of visual fields
Loss of visual acuity

26
Q

Idiopathic intracranial hypertension - investigations

A 
Lumbar puncture 
- over 25cm CSF 
CT 
- normal 
MRI 
- normal
27
Q

Idiopathic intracranial hypertension - management

A

Weight loss

28
Q

Hydrocephalus ex vacuo - definition

A

Because of a loss of brain parenchyma, the ventricles expand - as does the CSF - to accommodate the change in intracranial volume

29
Q

Hydrocephalus ex vacuo - name a disease that this occurs in

A

Alzheimers

Can occur in any disease that causes atrophy

30
Q

Syringomyelia - definition

A

Accumulation of water in the spinal cord

31
Q

Syringomyelia - clinical features

A

Clawed hands
Hyperhidrosis (abnormal sweating)
Involuntary movements

32
Q

Syringomyelia - which investigation confirms the diagnosis ?

A

MRI scan

Neurology SOH (31 decks)

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