Hydrocephalus Flashcards
definition of hydrocephalus
increased CSF volume
what is the hypothesis for increased CSF causing hydrocephalus called
Monroe kellie hypothesis
aetiology of hydrocephalus
too much CSF production
CSF drainage obstruction
inadequate CSF reabsorption
increased pressure in cranial cavity - tumour
what is the headache associated with in hydrocephalus
vomiting
when is the headache worst in hydrocephalus
worse in the morning
investigations for hydrocephalus
MRI
fundoscopy - for papilloedema
treatment of hydrocephalus
ventricular peritoneal shunt
how does a ventricular peritoneal shunt work
tube inserted from cranial cavity to peritoneal cavity where it is absorbed
can be a chronic treatment mechanism if congenital, or temporary if not
older person presents with;
dementia
shuffling gait
urinary incontinence
was fine a couple months ago
MRI shows large ventricles
normal pressure hydrocephalus
what is normal pressure hydrocephalus
when there is too much CSF in the cranial cavity, but the ventricles are large so pressure is normal
treatment of normal pressure hydrocephalus
ventricular peritoneal shunt
what causes normal pressure hydrocephalus
idiopathic
trauma
meningitis
which group of people get idiopathic benign intracranial hypertension
obese young females
treatment of idiopathic benign intracranial hypertension (4)
LOSE WEIGHT! but no one does lol
acetazolamide
loop diuretics
shunt
what is syringomyelia
when there is a syrinx cavity (type of cyst) in the spinal cord = expands over time and CSF destroys white matter of spinal cord
is syringomyelia common or rare
rare
most common causes of syringomyelia
spinal cord trauma = cyst in spinal cord
blocked CSF circulation = excess CSF (hydrocephalus)
how does syringomyelia present in terms of the nerve damage
spinothalamic sensory loss in the affected area (eg is in cervical spine = sensory loss in arms)
spinothalamic - so loss of pain and temperature but light touch/proprioception etc still in tact via dorsal column
apart form the nerve damage (pain and temp loss of sensation) how else does syringomyelia present
headache - worse on sneezing (hydrocephalus)
back stiffness
norners syndrome
hyperhidrosis (excessive sweating)
all symptoms exacerbated by sneezing/coughing
syringomyelia investigations
MRI - can see syrinx cavity in spinal cord
syringomyelia treatment
surgical decompression or analgesia (if surgery contraindicated)
what is the main cause of hydrocephalus in children (ie congenital)
aqueductal stenosis
how does a child with hydrocephalus present (4)
large head
thin shiny scalp with visible veins
sunsetting of eyes (eyes looking down)
failure to thrive
treatment of child with hydrocephalus (eg aqueductal stenosis)
shunt
