Path II final - hydrocephalus Flashcards
Accumulation of CSF in the VENTRICLES of brain
hydrocephalus
CSF is produced where?
choroid plexus
function of CSF
helps brain function properly
protects from trauma
total production CSF/day?
500 ml
total csf in ventricles at one time?
150 ml
CSF flow
Lateral Ventricle -> Interventricular Foramen of Monroe -> 3rd Ventricle -> Aqueduct of Sylvius -> 4th Ventricle -> Foramen of Leuscka (Latera Aperturel) and Foramen of Magendie (Medial Aperture) -> Cisterna Magna (Direct communication with subarachnoid space of brain and cord) -> Absorbed through Arachnoid Granulations -> Superior Saggital Sinus -> Transverse Sinus -> Sigmoid Sinus -> Jugular Vein -> Away from brain
Cisterna Magna has direct communication with this area
subarachnoid space
where CSF goes to reach the brain and spinal cord
subarachnoid space
space between the arachnoid and pia mater
subarachnoid space
space around the cerebellum
cisterna magna
direct communication with the subarachnoid space of brain and spinal cord
cisterna magna
Where is CSF absorbed?
arachnoid granulations (parietal bone)
Where does CSF flow to after being absorbed?
Sup. saggital sinus
Main collector of venous blood in the brain
superior saggital sinus
Made of the cranial vault above and sides are made by 2 layers of dura mater
superior saggital sinus
Which hydrocephalus causes acute bacterial infection?
communicating hydrocephalus
could be due to benign brain tumors with in the choroid plexus
communicating hydrocephalus
accumulation of extra fluid in brain due to increased production of CSF(or decreased absorption)
communicating hydrocephalus
has normal communication with structures of the brain
communicating hydrocephalus
An obstruction prevents CSF from moving out
due to Leptomeningitis or Brain Tumor or stroke (leads to increase in intracranial pressure)
non-communicating hydrocephalus
Swelling of Arachnoid Granulation
Causes increased accumulation (absorption) of CSF WITHIN VENTRICLES
leptomeningitis
Leads to headache- Gyri jam up against the skull and become flattened
leads to headache-gyro jam up against the skull and become flattened
Often of Pituitary Gland
Causes large cyst in the brain that CANNOT BE REMOVED
Causes obstruction of CSF flow
Leads to increased ICP
Tumor and Non-Communicating Hydrocephalus
3 Major Signs/Manifestations of Hydrocephalus
1) Headaches (often brain tumor)
2) Nausea/Vomiting
3) Papilledema (optic disc swelling)
___% of headaches may be treated with chiropractic care
18%
how many causes of headaches exist?
over 400
Swelling of the optic disc
A cardinal sign of hydrocephalus
palilledema
A brain atrophy disease
Amount of CSF is larger than normal due to disappearance of normal brain tissue
NO INCREASE in ICP because there is increased space due to brain atrophy
HYDROCEPHALUS EX-VACUO
Patients often have incontinence because the tissues that control this function have atrophied
Alzheimer’s
Another cause of hydrocephalus Ex-Vacuo -> Brain has atrophied
Chorea due to atrophy of striatal neurons (this space fills with CSF)
Damage to the basal ganglia
NO INCREASE in ICP -> Brain has atrophied and CSF takes the extra space
Huntington’s Disease
Atrophy of the Striatal Neurons -> Chorea
Damage to the Basal Ganglia
CSF fills in the extra space
Huntington’s disease
What determines the treatment of hydrocephalus?
Age of the patient
how many fontanelles do babies have?
Six
5 of them fuse in the first two months of life
The Frontal Fontanelle may take up to 18 months to fuse
What happens to the bones of a baby’s head with hydrocephalus?
They become distended
Measure circumference and both sides of head to check
MC cause of hydrocephalus
Birth process
Cranial bones overlap in the birth canal -> As bones separate and go back to normal, the Superior Saggital Sinus may become stuck -> Impairs CSF flow leading to Hydrocephalus
easiest way to treat hydrocephalus in baby
chiro adjustment
medical approach=insterting shunt
Treating Hydrocephalus in an adult
Cranial bones are fused = much more ICP
Can be very serious, leading to non-communicating hydrocephalus
Leads to Tonsillar Herniation -> Headaches
What is a common result of non-communicating hydrocephalus in adults?
Tonsillar Herniation -> Headaches
can cause incontinence
alzheimer’s
basal ganglia damaged
huntington’s