Hydrocephalus & Shunt Malfunction Flashcards
What symptoms are associated with normal pressure hydrocephalus (NPH)?
Gait disturbances, incontinence, dementia
A lumbar puncture is performed on a patient. The pathology report describes the CSF as xanthochromic. What does this mean?
The CSF is red/orange/yellow in color. This indicates that blood was within the CSF and heme has begun to be broken down to bilirubin.
This type of congenital hydrocephalus is associated with a genetic anamoly.
Syndromic hydrocephalus. Non-syndromic hydrocephalus is congenital, but is not associated with gene abnormalities
At what level should a lumbar puncture be performed?
Below L2 - L3/4 or L4/5
Where is CSF produced?
Choroid plexus of each ventricle
What is hydrocephalus ex-vacuo?
A hydrocephalus-like condition. There appears to be excess CSF, however, tissue surround the ventricles has shrunk/died and CSF filled the space
How is hydrocephalus typically diagnosed in infants and adults?
Ultrasound is used to diagnose hydrocephalus in fetuses and infants. MRI is commonly used to diagnose adults
What is the first step in treating non-communicating hydrocephalus?
Create a pathway for the flow of CSF to decrease pressure.
A patient is diagnosed with hydrocephalus, but there was not an obstruction in CSF flow. What is the type?
Communicating hydrocephalus - patent pathways, but accumulation of CSF
Where is most CSF found within the CNS?
Nearly half of CSF is within the ventricles
Hydrocephalus results from excessive CSF in the ventricles. How is it possible for CSF to accumulate?
Obstruction of normal flow, poor reabsorption of CSF by arachnoid granulations, excess production of CSF by the choroid plexus (rare)
Eyes that are fixed downward, called sun setting, may be an indication of hydrocephalus in what population?
Neonates
What are the treatment options for hydrocephalus?
Ventricular shunt or third ventriculostomy
Describe the production, flow, and reabsorption of CSF.
CSF is produced by the choroid plexus in the lateral ventricles.
From here, CSF flows through the intraventricular foramina to the third ventricle and then the cerebral aqueduct to the fourth ventricle. Each ventricle has a choroid plexus that produces more CSF. CSF exits the fourth ventricle to fill the subarachnoid space to surround the brain and spinal cord.
CSF is reabsorbed by arachnoid villi within the sagittal sinus.
What type of spina bifida is easier to treat and does not involve neuronal elements?
Meningocele