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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
Q

CSF is reabsorbed by

A

arachnoid granulation

26
Q

CSF after arachnoid granulations mediated reabsorption

A

drains into dural venous sinuses

27
Q

ventricular system - direction

A

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
Q

ventricular system - lateral ventricle to 3rd ventricle via

A

interventricular foramina of Monro

29
Q

ventricular system - 3rd ventricle –> 4th ventricle via

A

cerebral aqueduct (of Sylvius)

30
Q

ventricular system - 4th ventricle –> subarachnoid space via

A
  • Foramina of Luschka (lateral)

- Foramina of Mangendie (Medial)

31
Q

ventricular system - 4th ventricle –> subarachnoid space - lateral foramina

A

Foramina of Luschka

32
Q

ventricular system - 4th ventricle –> subarachnoid space - medial foramina

A

Foramina of Mangendie

33
Q

idiopathic intracranial hypertension is AKA

A

pseudotumor cerebri

34
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - definition

A

increased ICP with no apparent cause on imaging

35
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - symptoms and signs

A
  1. headache
  2. diplopia
  3. papilledema
  4. no mental status alternations
36
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - mental status

37
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - mechanism of diplopia

A

usually from CN VI palsy

38
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - clinical examination

A

papiledema

39
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - LP

A

increased opening pressure

headache relief

40
Q

idiopathic intracranial hypertension - induced headache is relief by

41
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - RISK FACTORS

A
  1. being woman on childbirth age
  2. vitamin A excess
  3. danazol
  4. tetracyclines
42
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - treatment

A
  1. weight loss
  2. acetazolamide
  3. topiramate
  4. invasive procedure for refractory cases
43
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - drugs

A
  1. acetazolamide

2. topiramate

44
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - invasive procedure for refractory cases

A
  1. repeat LP
  2. CSF shunt placement
  3. optic nerve fenestration surgery
45
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - treatment

A
  1. weight loss
  2. acetazolamide, topiramate
  3. topiramate
  4. invasive procedure for refractory cases

neurology FA (31 decks)

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