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hydrocephalus / ventricular system Flashcards

1
Q

Hydrocephalus - types

A
  1. Communicating (nonobstructive)
  2. Noncommunicating (obstructive)
  3. Hydrocephalus mimics
  4. normal pressure hydrocephalus (a particular form of communicating hydrocephalus)
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2
Q

Hydrocephalus mimics –>

A

Ex vacuo ventriculomegaly –> appearance of increased CSF on imaging, due to decreased brain tissue (neuronal atrophy)
(TRIAD IS NOT SEEN)

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3
Q

Ex vacuo ventriculomegaly –>

A

appearance of increased CSF on imaging, due to decreased brain tissue (neuronal atrophy)

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4
Q

Ex vacuo ventriculomegaly is the appearance of increased CSF on imaging, due to

A

decreased brain tissue (neuronal atrophy)

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5
Q

causes of Ex vacuo ventriculomegaly

A
  1. Alzheimer disease
  2. advanced HIV
  3. Pick disease
  4. Huntington disease
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6
Q

Ex vacuo ventriculomegaly - ICP?

A

normal

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7
Q

Noncommunicating hydrocephalus is caused by

A

structural blockage of CSF circulation WITHIN ventricular system

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8
Q

Noncommunicating hydrocephalus is caused by structural blockage of CSF circulation with ventricular system - examples?

A
  1. stenosis of aqueduct of Sylvius

2. colloid cyst blocking foramen of Monro

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9
Q

Communicating (nonobstructive) hydrocephalus - types

A
  1. communicating hydrocephalus

2. normal pressure hydrocephalus

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10
Q

communicating hydrocephalus - mechanism

A
  1. decreased CSF absorption by arachnoid granulations

2. increased CSF production.

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11
Q

communicating hydrocephalus - clinical findings

A
  1. increased ICP
  2. papilledema
  3. herniation
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12
Q

communicating hydrocephalus - example of a cause

A

arachnoid scaring post-miningitis

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13
Q

Normal pressure hydrocephalus - affects the

A

elderly

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14
Q

causes of Normal pressure hydrocephalus

A

idiopathic

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15
Q

Normal pressure hydrocephalus - CSF pressure?

A

elevated only episodically

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16
Q

Normal pressure hydrocephalus do not result in

A

increased subarachnoid space volume

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17
Q

Normal pressure hydrocephalus causes (and mechanism)

A

expansion of ventricles distorts the fibers of the corona radiata –> triad of 1. urinary incontinence 2. ataxia
3. cognitive dysfunction (sometimes reversible)
(Does not results in increased subarachnoid space volume)

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18
Q

normal pressure hydrocephalus - symptoms

A

triad of 1. urinary incontinence 2. ataxia

3. cognitive dysfunction (sometimes reversible)

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19
Q

normal pressure hydrocephalus - mechanism of triad

A

expansion of ventricles distorts the fibers of the corona radiata

20
Q

hydrocephalus - definition?

A

increase in CSF volume –> ventricular dilation +/- increased ICP

21
Q

triad of 1. urinary incontinence 2. ataxia

3. cognitive dysfunction - diagnosis?

A

normal pressure hydrocephalus

22
Q

brain tumor that can cause hydrocephalus

A
  1. Ependymoma
  2. meduloblastoma
  3. Pinelioma
23
Q

CSF is made by

A

ependymal cells of choroid plexus

24
Q

CSF is made by ependymal cells of

A

choroid plexus

25
CSF is reabsorbed by
arachnoid granulation
26
CSF after arachnoid granulations mediated reabsorption
drains into dural venous sinuses
27
ventricular system - direction
Lateral ventricle --> 3rd ventricle via right and left interventricular foramina of Monro --> 3rd ventricle --> 4th ventricle via cerebral aqueduct (of Sylvius) --> 4th ventricle --> subarachnoid space via: - Foramina of Luschka (lateral) - foramina of Mangendie (Medial)
28
ventricular system - lateral ventricle to 3rd ventricle via
interventricular foramina of Monro
29
ventricular system - 3rd ventricle --> 4th ventricle via
cerebral aqueduct (of Sylvius)
30
ventricular system - 4th ventricle --> subarachnoid space via
- Foramina of Luschka (lateral) | - Foramina of Mangendie (Medial)
31
ventricular system - 4th ventricle --> subarachnoid space - lateral foramina
Foramina of Luschka
32
ventricular system - 4th ventricle --> subarachnoid space - medial foramina
Foramina of Mangendie
33
idiopathic intracranial hypertension is AKA
pseudotumor cerebri
34
idiopathic intracranial hypertension (pseudotumor cerebri) - definition
increased ICP with no apparent cause on imaging
35
idiopathic intracranial hypertension (pseudotumor cerebri) - symptoms and signs
1. headache 2. diplopia 3. papilledema 4. no mental status alternations
36
idiopathic intracranial hypertension (pseudotumor cerebri) - mental status
normal
37
idiopathic intracranial hypertension (pseudotumor cerebri) - mechanism of diplopia
usually from CN VI palsy
38
idiopathic intracranial hypertension (pseudotumor cerebri) - clinical examination
papiledema
39
idiopathic intracranial hypertension (pseudotumor cerebri) - LP
increased opening pressure | headache relief
40
idiopathic intracranial hypertension - induced headache is relief by
LP
41
idiopathic intracranial hypertension (pseudotumor cerebri) - RISK FACTORS
1. being woman on childbirth age 2. vitamin A excess 3. danazol 4. tetracyclines
42
idiopathic intracranial hypertension (pseudotumor cerebri) - treatment
1. weight loss 2. acetazolamide 3. topiramate 4. invasive procedure for refractory cases
43
idiopathic intracranial hypertension (pseudotumor cerebri) - drugs
1. acetazolamide | 2. topiramate
44
idiopathic intracranial hypertension (pseudotumor cerebri) - invasive procedure for refractory cases
1. repeat LP 2. CSF shunt placement 3. optic nerve fenestration surgery
45
idiopathic intracranial hypertension (pseudotumor cerebri) - treatment
1. weight loss 2. acetazolamide, topiramate 3. topiramate 4. invasive procedure for refractory cases

neurology FA (31 decks)

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