Neuropathology 3

Question 1

what are normal ICP values

Answer 1

5-13mmHg

Question 2

what is hydrocephalus

Answer 2

accumulation of excessive CSF within the ventricular system of the brain

Question 3

what is the normal volume of CSF

Answer 3

120-150ml

Question 4

where is csf produced

Answer 4

by the choroid plexus in the lateral and fourth ventricles

Question 5

what reabsorbs CSF

Answer 5

arachnoid granulations

Question 6

what is the typical daily csf turnover

Answer 6

500ml (3-5 times per day )

Question 7

is blood usually present in CSF

Answer 7

NOOO

Question 8

what are the normal findings in CSF

Answer 8

lymphocytes less than 4/mm3
protein less than 0.4g/l
glucose more than 2.2mmol/l

Question 9

where is csf absorbed

Answer 9

superior sagittal sinus

Question 10

what is the difference between non communicating and communicating hydrocephalus

Answer 10

non communicating - obstruction to flow of CSF is within ventricles

communticatin - obstruction is outside the ventricles eg arachnoid granulations

Question 11

what happens if hydrocephalus develops before closure of cranial sutures

Answer 11

head enlarges

if after they have closed - raised ICP

Question 12

what herniated in subfalcine herniation

Answer 12

cingulate gyrus under falx cerebri

Question 13

what symptoms result in subfalcine herniation

Answer 13

compresses anterior cerebral artery - weakness/sensory loss in lower limbs

Question 14

what is a tentoral hernia

Answer 14

hippocampal uncus and parahippocampal gyrun herniates over the tentorium cerebelli

Question 15

what symptoms occur in tentoral hernia

Answer 15

third nerve palsy

Question 16

what is a tonsilar herniation

Answer 16

dispplacemnt of cerebellar tonsils through foramen magnum

Question 17

why is a tonsillar hernia particularly dangerous

Answer 17

braistem compression compromises respiratory centres in medulla oblongata

Question 18

what is a trancalcarium hernia

Answer 18

swollen brain will herniate though defect in dura or skull

Question 19

CARDINAL SIGNS OR RAISED ICP

Answer 19

papilledema
headache
vomiting
neck stiffness

Question 20

what is the most common type of primary brain tumour

Answer 20

atrocytoma

Question 21

what is the most common benign brain tumour in adults

Answer 21

menigioma

Question 22

what is the most common brain tumour in children that is benigm

Answer 22

craniopharyngioma

Question 23

what is the difference between primary and secondary glioblastoma (ie a grade four astrocytoma)

Answer 23

primary means that gliobastoma has arisen from normal brain tissue

secondary means it has progressed from lower grade astrocytomas ie anaplastic or diffuse astocytomas

secondary has slightly better prognosis but both prognosis are poor with mean survival les than 12 months

Question 24

what age do people usually present with primary glioblastoma

Answer 24

mean is 62

Question 25

what age do people usually present with secondary glioblastoma

Answer 25

mean is 45 yrs

Question 26

how do brain tumours present

Answer 26

most with focal neurological deficit and headache also vomiting seizures and visual disturbance

Question 27

what usually causes a single absess

Answer 27

``` otitis media sinusitis dental infections skull fracture neurosurgery ``` can arise without significant bacterial menigitis

Question 28

what usually causes multiple absesses

Answer 28

usually from septicaemia eg endocarditis lung absess intravenous drug use

Question 29

what is cerebral oedema

Answer 29

increased water content of the brain

Question 30

what type of cerebral oedema is seen in hypertensive encephalopathy

Answer 30

hydrostatic

Question 31

what is the source of the bleed in extradural haemorrhages

Answer 31

meningeal arteries - usually middle menigeal

Question 32

why are extra durals 'walk and die' injuries

Answer 32

results in uncal and cerebella herniation - death

Question 33

what is the source of the blood in subdurals

Answer 33

bridging veins from surface of brain into subdural space

Question 34

what type of brain bleed can be confused with dementia

Answer 34

chronic subdural

Question 35

where do most berry aneurysms arise

Answer 35

in internal carotid

Question 36

what haemorrhage do berry aneurysm causes

Answer 36

subarachnoid

Question 37

are subarachnoid more common in women or men

Answer 37

women