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Neuro - Pathology > Hydrocephalus > Flashcards

Hydrocephalus Flashcards

1
Q

where the CSF is produced

A

choroid plexus that lines the lateral ventricles

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2
Q

where is CSF drained

A

through the arachnoid granulations into the superior sagittal sinus

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3
Q

how many times a day does CSF volume replace itseld

A

3/4

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4
Q

cerebral aqueduct connects what ventricles

A

3rd and 4th

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5
Q

what makes arachnoid granulations open to CSF

A

pressure becoming greater than dural venous sinus pressure and opening one-way valves

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6
Q

true/false CSF production uses ATP

A

true

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7
Q

true/false CSF production uses ATP

A

false - passive process driven by pressure gradient

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8
Q

two types of hydrocephalus

A

communicating and non-communicating

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9
Q

4 causes of a communicating hydrocephalus

A

infection, subarachnoid haemorrhage, post-operative and head trauma

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10
Q

infection can cause non/communicating hydrocephalus

A

both

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11
Q

how does a subarachnoid haemorrhage cause communicating hydrocephalus

A

increases ICP by increasing volume and also by the blood scarring the arachnoid granulations and obstructing reabsorption

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12
Q

pathophysiology of non-communicating hydrocephalus

A

obstruction of the normal CSF pathway

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13
Q

aquecuctal stenosis, tumours, cysts, infection, haemorrhage and congenital malformation may all cause what

A

non-communicating hydrocephalus

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14
Q

which nerve is damaged in raised ICP

A

the 6th (trochlea) because it has the longest intercranial course

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15
Q

3 Ws of normal pressure hydrocephalus

A

wet, wobbly and wacky

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16
Q

scan used to view ventricles in raised ICP

A

CT

17
Q

two ratios of measuring ventricles on CT

A

Evan’s and ventricular index

18
Q

urgent treatment of hydrocephalus

A

urgent external ventricular drain

19
Q

long term treatment of hydrocephalus

A

a shunt –> can cause headache and infection

20
Q

where do shunts drain from and to

A

ventricle or spine to atria or peritoneum

21
Q

complication of an LP in raised ICP

A

herniation (coning)

22
Q

what hydrocephalus is a rare and preventable cause of dementia

A

normal pressure hydrocephalus

23
Q

what is contradictory about normal pressure hydrocephalus

A

LP in normal pressure but dilated ventricles on CT

24
Q

what type is a 3rd ventriculostomy an option

A

in non-communicating - opens the ventricle space back up

25
Q

brain receives how much of the cardiac output

A

15%

26
Q

cerebral perfusion pressure =

A

mean arterial pressure - intracranial pressure

27
Q

range of CPP that cerebral blood flow autoregulation can work

A

50-150mmHg

28
Q

carbon dioxide is a vasoconstrictor/dilator

A

vasodilation

29
Q

what cells make the blood brain barrier

A

astrocytes

30
Q

what does the monro-kelly doctrine tell us

A

when a new intracranial mass in introduced there will be a compensatory change in volume through decrease of venous blood or CSF to maintain a constant intracranial volume

31
Q

what do C waves correspond to

A

waves of blood pressure through systolic and diastolic

32
Q

what do B waves correspond to

A

breathing

33
Q

what do A waves correspond to

A

an abrupt elevation in ICP for 5-20 mins as high as 50/10mmHg

34
Q

what is Cushing’s reflex

A

a nervous system response to reduce ICP by increasing BP, slowing heart rate and an irregular resp rate

35
Q

what is Cushing’s triad

A

hypertension, bradycardia, irregular resp rate

36
Q

when do you see cushing’s triad (i.e. in what condition)

A

coning

37
Q

presentation of coning

A

cushing’s triad, altered mental status and cranial nerve defects

38
Q

treating raised ICP

A

head elevated
fluids (mannitol or hypertonic saline)
surgical decompression

Neuro - Pathology (12 decks)

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