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Y2 Neurology > Hydrocephalus > Flashcards

Hydrocephalus Flashcards

1
Q

what colour is CFS normally?

A

clear

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2
Q

what is the function of CSF?

A

shock absorber
removal of some waste products
some immunological function

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3
Q

what conc of RBCs should be in CSF normally?

A

0

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4
Q

what is the normal volume of CSF?

A

150ml

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5
Q

where is CSF produced?

A

choroid plexus

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6
Q

where is CSF absorbed ?

A

arachnoid villi

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7
Q

what sinus is the CSF absorbed into ?

A

the superior sagittal sinus

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8
Q

what is the normal pressure of the CSF ?

A

0-20 cm

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9
Q

how does the CSF pass from the ventricles to the sub arachnoid space?

A

passes through lateral appendatures in the 4th ventricle

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10
Q

what two types of hydrocephalus are there?

A

obstructive

communicating

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11
Q

what cause obstructive hydrocephalus ?

A

when there is a blockage of outflow from the ventricles

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12
Q

what causes communicating hydrocephalus ?

A

Block at the level of the arachnoid granulations

- mismatch between production and absorption of the CSF

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13
Q

what are the signs and symptoms of hydrocephalus ?

A 
raised ICP symptoms 
- vomiting 
- confusion 
- reduced GCS 
head ache (worse when coughing) 
can't look up 
visual disturbances
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14
Q

what investigation should be done for hydrocephalus ?

A

CT head scan

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15
Q

what investigation can be done for visual disturbances due to check raised ICP ?

A

fundoscopy

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16
Q

what should the CT scan look like for obstructive hydrocephalus ?

A

the lateral and 3rd ventricles would be enlarged but the 4th ventricle would be normal sized

17
Q

what would suggest raised ICP on a CT scan?

A

not being able to see the gyri and sulci

18
Q

is obstructive hydrocephalus a medical emergency ?

A

yes

19
Q

two main categories of the cause of hydrocephalus is congenital and acquired

A

congenital =
chiari malformation
aqueduct stenosis

acquired = 
meningitis 
post haemorrhage 
neoplasm 
cerebellar stroke 
post traumatic
20
Q

are babies or adults better at adapting to hydrocephalus ?

A

babies because their fontanelles haven’t fused yet so their head can increase in size

21
Q

what medicine can be used to treat hydrocephalus ?

A

acetazolamide

22
Q

how does acetazolamide work?

A

decreases production of CSF from the choroid plexus

23
Q

what 4 surgical options for hydrocephalus are there?

A

EVD (external ventricular drain)
Eliminating obstruction
ETV (endoscopic third ventriculostomy)
CSF diversions

24
Q

what is done during ETV (endoscopic third ventriculostomy)?

A

Hole is pierced in the inferior wall of the 3rd ventricle so CFS can flow from 3rd ventricle to subarachnoid space

25
Q

what are the complications of inserting a shunt for CSF diversion ?

A 
over/under drainage 
infection 
blockage 
disconnections 
seizures 
bowel can wrap around tube
26
Q

what causes normal pressure hydrocephalus ?

A
  • Brain is shrinking away form age and ventricles get larger
27
Q

what is the main risk factor for normal pressure hydrocephalus ?

A

age

28
Q

what is the classical triad of normal pressure hydrocephalus ?

A

dementia
gait disturbances
urinary incontinence

29
Q

what is the treatment for normal pressure hydrocephalus ?

A

lumbar puncture

30
Q

what is idiopathetic intracranial hypertension ?

A

partial obstruction to the absorption of CSF so pressures increases

31
Q

when would a lumbar puncture not be done?

A

if the CT scan is normal and there is no obstruction causing hydrocephalus

32
Q

when would a lumbar puncture be preformed ?

A 
infection (meningitis)
haemorrhage 
inflammation 
measuring the pressure of CSF
communicating hydrocephalus
33
Q

what are some risks of lumbar puncture ?

A 
bleeding 
infection 
nerve root injury 
headache 
abdominal viscera injury 
brain stem herniation

Y2 Neurology (52 decks)

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