Raised ICP, SOL's & Trauma

Question 1

What part of the dura separates the cerebral hemisphere?

Answer 1

Falx Cerebri

Question 2

What part of the dura lays just superior to the cerebellum?

Answer 2

Tentorium cerebelli

Question 3

How should CSF appear normally?

Answer 3

Essentially clear
- May be a very small number of lymphocytes

Question 4

What level should CSF glucose be?

Answer 4

> 2.2mol/L

Question 5

What can cause a reduction in CSF reabsorption?

Answer 5

Post Sub-arachnoid haemorrhage
Meningitis

Question 6

What is the difference between communicating & non-communicating hydrocephalus?

Answer 6

In non-communicating there is an obstruction to CSF flow within the ventricular system. whereas, is communicating the obstruction is outside of the ventricular system.

Question 7

How do ventricles become enlarged in Hydrocephalus ex Vacuo?

Answer 7

Loss of brain parenchyma means ventricles enlarge and volume of CSF increases to compensate for loss of brain mass

Question 8

What is an example of a disease process that can lead to Hydrocephalus ex Vacuo?

Answer 8

Alzheimer’s

Question 9

How can subfalcine herniation manifest clinically?

Answer 9

Weakness of contralateral leg

Question 10

How can tentorial herniation manifest clinically?

Answer 10

Pupillary dilation
Lack of pupil response to light
Ipsilateral impairment of ocular movement

Question 11

How can tonsillar herniation manifest clinically?

Answer 11

Death
Compromises respiratory center

Question 12

Where are childhood cancers most likely to present?

Answer 12

70% below tentorium cerebelli

Question 13

Where are metastatic brain tumours most likely to be found?

Answer 13

Border between white & grey matter

Question 14

What is the most common brain tumour in children?

Answer 14

Medulloblastoma

Question 15

Where are medulloblastomas located?

Answer 15

Midline of the cerebellum

Question 16

What is multiple abscesses indicative of?

Answer 16

Haematogenous spread

Question 17

How is abscess diagnosed?

Answer 17

CT or MRI showing ‘ring enhancing lesion’

Question 18

What is the most likely causative organism of bacterial meningitis in neonates?

Answer 18

E coli

Question 19

What is the most likely causative organism of bacterial meningitis in infants & children?

Answer 19

H Influenzae

Question 20

What is the most likely causative organism of bacterial meningitis in Adolescents & young adults?

Answer 20

N Meningitidis

Question 21

What is the most likely causative organism of bacterial meningitis in older adults or children?

Answer 21

S pneumoniae

Question 22

What is the difference between primary and secondary brain injury?

Answer 22

Primary - At the time of insult
Secondary - Injury that accumulates after incident

Question 23

What are brain contusions?

Answer 23

Basically brain bruises

Question 24

Where in the brain is most susceptible to diffuse axonal injury?

Answer 24

Central areas (i.e. brainstem, corpus callosum etc.)

Question 25

Are haematomas more likely to be intradural or extra-dural?

Answer 25

80% intradural

Question 26

The disruption of which artery is most likely to cause extradural haematoma?

Answer 26

Middle meningeal artery

Question 27

What causes subdural haematoma?

Answer 27

Disruption of bridging veins

Question 28

Are extradural or subdural haemorrhages more associated with trauma?

Answer 28

Subdural