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Neurology > Hydrocephalus > Flashcards

Hydrocephalus Flashcards

1
Q

Normal pressure hydrocephalus triad (Hakim’s triad)

A

Difficulty walking/abnormal gait
urinary incontinence
dementia

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2
Q

what does the skull contain

A

brain
blood
CSF

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3
Q

what is the normal range of ICP

A

7-15mmHg

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4
Q

pathway of CSF production and circulation

A 
choroid plexus in lateral ventricles
interventricular foramen of monro
3rd ventricle 
cerebral aqueduct
4th ventricle 
foramen of magendie and luschka 
subarachnoid space
arachnoid granulation 
dural venous sinuses
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5
Q

what is the equation including ICP, MAP + CPP

A

CPP = MAP - ICP

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6
Q

MAP = DBP + _PP

A

1/3PP

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7
Q

does CPP = CBF

A

no

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8
Q

what is Cushing’s response

A

occurs in the case of raised ICP

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9
Q

features of Cushing’s response

A

hypertension
bradycardia
irregular breathing

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10
Q

over which BP ranges does autoregulation occur

A

50-150mmHg

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11
Q

raised CO2 causes cerebral vasodilatation/constriction

A

vasodilatation

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12
Q

hypo/hyperventilation causes raised CO2

A

hypoventilation increases CO2

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13
Q

low CO2 causes cerebral vasodilatation/constriction

A

vasoconstriction

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14
Q

hypo/hyperventilation causes low CO2

A

hyperventilation

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15
Q

causes of raised ICP

A

mass effect
oedema
impaired venous outflow
CSF / hydrocephalus

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16
Q

signs and symptoms of raised ICP

A 
drowsy
slow 
anisocoria (difference in pupil size)
papilloedema 
Cushing's response
N+V
hyperthermia
17
Q

supportive management of raised ICP

A 
maintain head in midline
head of bed at 30 degree angle 
treat hyperthermia 
maintain fluid and electrolyte balance
maintain normocarbia
18
Q

medical management of raised ICP

A 
mannitol, hypertonic saline, furosemide, urea
barbiturate induced coma (last line)
anti epileptic drugs 
surgical decompression 
remove mass 
CSF shunt
19
Q

list types of hydrocephalus

A 
communicating
non-communicating 
congenital 
acquired
normal pressure
20
Q

what is communicating hydrocephalus

A

CSF obstruction outwith ventricles

ALL ventricles are enlarged

21
Q

what is non-communicating hydrocephalus

A

CSF obstruction within ventricular system
enlargement of lateral and 3rd ventricles only
normal 4th ventricle

22
Q

what is a non-communicating hydrocephalus also known as

A

obstructive hydrocephalus

23
Q

clinical features of obstructive/non-communicating hydrocephalus

A

swollen head

sunset eyes / upgaze paralysis

24
Q

what is a colloid cyst

A

benign epitheliated cyst usually located at foramen on monro

25
Q

hydrocephalus ex vacuo is a true hydrocephalus, true or false

A

false

it is as a result of brain atrophy

26
Q

what is normal pressure hydrocephalus

A

idiopathic disease of the elderly

27
Q

what is seen on a scan of someone with normal pressure hydrocephalus

A

large ventricles and large sylvian fissures

28
Q

management of normal pressure hydrocephalus

A

lumbar drain test
lumbar infusion studies - less done
MoCA and MMSE done before and after lumbar drain for comparison
VP shunt with low pressure valve

29
Q

what is idiopathic intracranial hypertension IIH also known as

A

pseudotumour cerebri

30
Q

who is affected by IIH

A

young obese women of child bearing age

31
Q

is there ventricular dilatation in IIH on imaging

A

no

imaging will look normal

32
Q

signs and symptoms of IIH

A 
debilitating headache 
double vision and blurring 
pulsatile tinnitus 
radicular pain 
papilloedema
33
Q

investigations for IIH

A

LP
CT, MRI
CTV
fundoscopy and ophthalmology

34
Q

management of IIH

A 
weight loss 
acetozolamide (carbonic anhydrase inhibitor)
topiramate
diuretics
VP shunt

Neurology (25 decks)

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