Hydrocephalus

Question 1

Which shunt valve is good for high csf protein

Answer 1

Mitre valve.

Mitre = mouth.
Sound like Integra

Question 2

Example of slit valve

Answer 2

Sophysa Phoenix.

Phoenix = female = slit

Question 3

Example of diaphragm valve

Answer 3

Sophysa pulsar

Diaphragm pulsars

Question 4

How progav programmable valve work

Answer 4

Ball in cone. Spring determines pressure resistance.

Rotor on a step platform can be adjusted by magnet, which pushes on the spring and adjusts the resistance of spring, and therefore pressure of valve

Question 5

Example of ball and cone valve

Answer 5

Codman hakim fixed pressure

Question 6

Modified dandy criteria for IIH

Answer 6

3 clinicals

1. Symptoms and signs of raised icp
2. Awake and alert
3. No focal deficit except false localising sign of CN6
4. No abnormal radiology findings except empty sella and slit ventricle
5. LP more than 20cmH20 non obese or 25cmH20 in obese
6. No other causes of raised ICP (Ie, check csf etc)

Question 7

Theories of syrinx formation

Answer 7

Gardner water hammer: pulses of csf thru obex due to obstruction, causing a syrinx

Ball and dayan: increased ISP, forces fluid into central canal through Virchow robin spaces and nerve roots

Williams: craniospinal gradient, hindbrain impaction and gradient

Oldfield: piston of the tonsils can piston csf into a syrinx

Question 8

Icp monitor mechanisms

Answer 8

Strain gauge: codman
(Strain cod)

Fibreoptic: Camino
(FC)

Pneumatic: spiegelberg
(PS)