Meninges, Ventricles and CSF

Question 1

Epidural Hematoma:
What shape do they take on a CT?
Is lateral expansion of blood stopped? If so, where?
How else does blood expand?

Answer 1

Convex or lens shape
Expansion stops at skull sutures
Inward towards the brain

Question 2

Subdural Hematoma:
What shape do they take on a CT?
Is lateral expansion of blood stopped? If so, where?
What does pattern does expansion follow?

Answer 2

Concave or crescent shape
Expansion stops at dural reflections
Expansion follows curvature of the brain

Question 3

How would bleeding of a meningeal artery present?

Answer 3

Epidural hematoma

Question 4

How would bleeding of a dural venous sinus present?

Answer 4

Epidural or subdural hematoma

Question 5

How would bleeding of a vein attached to a venous sinus present?

Answer 5

Subdural hematoma

Question 6

How would bleeding of a cerebral artery or vein present?

Answer 6

Subarachnoid hemorrhage
Intraparenchymal hemorrhage
Intraventricular hemorrhage

Question 7

Cerebral Herniation:
Cause
Result

Answer 7

Hematoma pushing mass against contralateral side of brain

Little or no consequence

Question 8

Uncal Herniation:
Cause
Result

Answer 8

Expanding mass in temporal lobe - midbrain against tentorium– herniation through “tentorial notch”
Blown pupil, coma, death

Question 9

Tonsillar Herniation:
Cause
Result

Answer 9

tonsil of cerebellum can herniate through foramen magnum
can compress cardio/resp centers
Rapidly fatal–worst!

Question 10

How many ventricles are there?

What are their names?

Answer 10

4
Left and right lateral ventricles
Third ventricle
Fourth ventricle

Question 11

Left and Right Lateral Ventricles:
Location
Parts

Answer 11

Curve through each cerebral hemisphere

Anterior horn, body, posterior horn, inferior horn and atrium

Question 12

Third Ventricle:
Location
Shape

Answer 12

Midline cavity in diencephalon

Donut-like with hole corresponding to interthalamic adhesions

Question 13

Fourth Ventricle:
Location
Shape

Answer 13

Between pons and rostral medulla anteriorly and cerebellum posteriorly
Tent with double-peaked roof

Question 14

What structures do the left and right interventricular foramina (Foramina of Monro) connect?

Answer 14

Left and right lateral ventricles and the third ventricle

Question 15

What structures does the cerebral aqueduct (Aqueduct of Sylvius) connect?

Answer 15

Third and fourth ventricles

Question 16

What structures does the median aperture (Foramen of Megendie) connect?

Answer 16

Fourth ventricle and cerebromedullary cistern

Question 17

What structures do the left and right lateral apertures (Foramina of Luschka) connect?

Answer 17

Fourth ventricle and quadrigeminal cistern

Question 18

Choroid Plexus:
Location
Structure
Function
Blood supply

Answer 18

In each ventricle
Pia mater extensions into ependymal lining of ventricles
Produce CSF
Anterior choroidal artery via internal carotid artery and medial and lateral posterior choroidal arteries via posterior cerebral artery

Question 19

What is the circulation path of CSF?

Answer 19

Choroid plexus
Ventricles
Subarachnoid space
Arachnoid villi
Venous sinuses
Internal jugular vein

Question 20

communicating hydrocephalus

Answer 20

CSF flows into superior sagittal sinus
no obstruction of ventricles
IMPAIRED CSF REABSORPTION
can be caused by meningitis

Question 21

Non-communicating hydrocephalus

Answer 21

CSF outflow obstructed (at foramen of monro, aqueduct, 4th ventricle, foramen of luschka or magendie)

abnormal accumulation of CSF in brain, increased intracranial pressure