Meninges and Ventricles

Question 1

3 Components of the Choroid Plexus

Answer 1

1. Fenestrated Endothelial Capillary Wall
2. Pial Cells
3. Choroidal epithelium (creates blood-CSF barrier)

Question 2

Classic presentation for Sub-arachnoid hemorrhage is a _____-onset, espeically if it’s non-traumatic

Answer 2

Sudden

Question 3

Communicating vs Non-communicating Hydrocephalus

Answer 3

Communicating means that the fluid travels throughout all the ventricles

Question 4

Key MRI finding of Subdural Hematoma, usually caused by rapid accelerations

Answer 4

Hemisphere-localized “crescent” pool (blood doesn’t travel)

Question 5

For normal CSF flow, you go from the Lat. Ventricles to ______ which leads into the 3rd Vent, and then drain in the _______ _____ leading to the 4th ventricle which then goes through ______ and ______ leading into the subarachnoid space, arachnoid granulations, and ultimately venous sinuses

Answer 5

• Interventricular Foramen of Monroe
• Cerebral aqueduct
• Foramen of Magendie, and Luschka

Question 6

2 Components of Blood-brain barrier

Answer 6

1. Capillary endothelium
2. Astrocyte Foot process

Question 7

Two key distinguishing factors of Epidural Hematoma (usually caused by the Middle Meningeal Artery)

Answer 7

1. Crosses form left to right of brain because not hindered by dura
2. Forms “lens shape” on MRI

Question 8

Out of the three meningeal spaces, which is the only real space?

Answer 8

Subarachnoid Space

Question 9

Headache, nuchal rigidity, light sensitivity, noise sensitivity, and lethargy are all signs of ______ irritation

Answer 9

Meningeal

Question 10

Chiari I vs Chiarai II Neural malformations

Answer 10

• Chiari I is mainly in Cerebellar tonsils
• Chiari II has SIGNIFICANT herniation through foramen magnum

Question 11

Two main components of infratentorial region in the brain

Answer 11

1. Cerebellum
2. Brainstem

Question 12

_____ Malformations are associated with downward displacement of the cerebellum, brainstem, or craniocervical junction

Answer 12

Chiari

Question 13

What is papilledema and what is it an important sign of?

Answer 13

Engorgement of optic disc, important sign of Increased Cranial pressure

Question 14

Out of the 3 Meningeal spaces, which 2 are only potential spaces?

Answer 14

Subdural Space (btwn dura and arachnoid)

• Epidural (dura and skull)

Question 15

2 Key differences between Blood-brain barrier and Blood-CSF barrier

Answer 15

1. Blood brain transports glucose/proteins vs blood-CSF transporting ions
2. BBB protects from toxins

Question 16

Classic triad of Normal Pressure Hydrocephalus

Answer 16

1. Gait disturbance
2. Dementia
3. Urinary Incontincence

“Wacky, Weird, and Wet”

Question 17

If you see hydrocephalus without Gait disturbance, dementia, or Urinary incontinence , then you would expect what type of hydrocephalus? (caused by what 4 things)

Answer 17

Hydrocephalus Ex Vacuo; Caused by aging, neurodegeneration, trauma, or surgery

Question 18

Aside from neck bain, blurred vision, and 6th nerve palsy, what are 3 key symptoms of hydrocephalus?

Answer 18

1. Headache in morning

2 Vomiting in morning

3. Downward eyes

Question 19

The most common sites of aneurysm for men is ______ and for women is ______

Answer 19

• Anterior Communicating Artery (ACom)
• Posterior communicating artery (PComm)

Question 20

Failure of looking to which direction is a sign of Hydrocephalus?

Answer 20

Upward

Question 21

Cushing’s triad from Increased Intracranial Pressure

Answer 21

1. Hypertension
2. Bradycardia
3. Irregular respirations

Question 22

Normal CSF pressure is _____mm

Answer 22

200