Hydrocephalus

Question 1

definition of hydrocephalus

Answer 1

increased CSF volume

Question 2

what is the hypothesis for increased CSF causing hydrocephalus called

Answer 2

Monroe kellie hypothesis

Question 3

aetiology of hydrocephalus

Answer 3

too much CSF production
CSF drainage obstruction
inadequate CSF reabsorption
increased pressure in cranial cavity - tumour

Question 4

what is the headache associated with in hydrocephalus

Answer 4

vomiting

Question 5

when is the headache worst in hydrocephalus

Answer 5

worse in the morning

Question 6

investigations for hydrocephalus

Answer 6

MRI

fundoscopy - for papilloedema

Question 7

treatment of hydrocephalus

Answer 7

ventricular peritoneal shunt

Question 8

how does a ventricular peritoneal shunt work

Answer 8

tube inserted from cranial cavity to peritoneal cavity where it is absorbed

can be a chronic treatment mechanism if congenital, or temporary if not

Question 9

older person presents with;
dementia
shuffling gait
urinary incontinence

was fine a couple months ago

MRI shows large ventricles

Answer 9

normal pressure hydrocephalus

Question 10

what is normal pressure hydrocephalus

Answer 10

when there is too much CSF in the cranial cavity, but the ventricles are large so pressure is normal

Question 11

treatment of normal pressure hydrocephalus

Answer 11

ventricular peritoneal shunt

Question 12

what causes normal pressure hydrocephalus

Answer 12

idiopathic
trauma
meningitis

Question 13

which group of people get idiopathic benign intracranial hypertension

Answer 13

obese young females

Question 14

treatment of idiopathic benign intracranial hypertension (4)

Answer 14

LOSE WEIGHT! but no one does lol
acetazolamide
loop diuretics
shunt

Question 15

what is syringomyelia

Answer 15

when there is a syrinx cavity (type of cyst) in the spinal cord = expands over time and CSF destroys white matter of spinal cord

Question 16

is syringomyelia common or rare

Answer 16

rare

Question 17

most common causes of syringomyelia

Answer 17

spinal cord trauma = cyst in spinal cord

blocked CSF circulation = excess CSF (hydrocephalus)

Question 18

how does syringomyelia present in terms of the nerve damage

Answer 18

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

Question 19

apart form the nerve damage (pain and temp loss of sensation) how else does syringomyelia present

Answer 19

headache - worse on sneezing (hydrocephalus)
back stiffness
norners syndrome
hyperhidrosis (excessive sweating)

all symptoms exacerbated by sneezing/coughing

Question 20

syringomyelia investigations

Answer 20

MRI - can see syrinx cavity in spinal cord

Question 21

syringomyelia treatment

Answer 21

surgical decompression or analgesia (if surgery contraindicated)

Question 22

what is the main cause of hydrocephalus in children (ie congenital)

Answer 22

aqueductal stenosis

Question 23

how does a child with hydrocephalus present (4)

Answer 23

large head
thin shiny scalp with visible veins
sunsetting of eyes (eyes looking down)
failure to thrive

Question 24

treatment of child with hydrocephalus (eg aqueductal stenosis)

Answer 24

shunt