Section 3 - Ventricles, Meninges, and Brain Blood Supply Flashcards
What are the symptoms and increased intracranial pressure? (seems like we probably ought to know these…)
Vomiting/nausea, lethargy, headache. (possible papilledema)
Generally, what is fetal hydrocephalus?
CSF flow block leads to enlargement of ventricular system upstream and bones of the skull move apart –> significant head enlargment.
How do we treat fetal hydrocephalus?
Shunting of CSF.
Infection or developmental defect can lead to glial scarring, which can lead to occlusion of ______
Cerebral aqueduct. Leads to buildup in 3rd ventricle and lateral ventricles.
Tumors of the ______, such as ______, can compress midbrain and occlude aqueduct (any time in life).
Midbrain; pinealoma
What is a colloid cyst?
Type of glioma in interventricular foramen that blocks CSF flow –> enlarged lateral ventricles, thinning of corpus callosum.
What are symptoms of a colloid cyst?
Headache, nausea, vomiting, mental change, gait disturbances.
What is a calcified glomus indicative of?
White spots on CT. Shifts in position of glomus indicative of alterations to ventricle system or a lesion. (The glomus is in the atrium).
List some potential causes of hemorrhage into the ventricles:
- Cerebral hemorrhage (into substance of brain)
- Intracranial aneurysm rupture
- Severe head trauma
- Arteriovenous malformations
- Tumor invasion
A choroid plexus tumor in the IV foramen would cause enlargement of the ______
lateral ventricle on the side with signs/symptoms (vomiting, lethargy, headache, maybe papilledema…not to beat the dead horse)
Choroid plexus papillomas are usually benign and more common than carcinomas - most common in ______
fourth ventricle
Patients with choroid plexus tumors can present with:
increased intracranial pressure (and accompanying symptoms…which you ought to know by now), hydrocephalus, and nerve signs (3, 4, 6) - eye movements
Treatment for choroid plexus papilloma:
For the carcinoma:
- surgical
- chemo, surgery, chemo/radiation
Where is a lumbar puncture done?
between L3,4 or L4,5 into the dural sac (lumbar cistern)
What is a traumatic tap?
Blood in the CSF due to bleeding from the procedure (like hit an artery)
How do you differentiate between a traumatic tap and blood in the CSF?
Draw 3 tubes - third tube shouldn’t have blood if it was a traumatic tap. Blood in every one could indicate subarachnoid hemorrhage.
Lumbar puncture (LP) in bacterial meningitis or brain abscess will have:
predominate neutrophils, elevated protein
LP in syphilitic meningitis, viral meningitis, encephalitis will have:
predominate lymphocytes
LP in MS will have:
increased IgG, mononuclear cells
LP in subarachnoid hemorrhage will have:
numerous RBC, elevated protein
TP in tumor will have:
elevated protein (if metastastized)
Obstructive hydrocephalus
blockage of CSF flow
Aqueductal stenosis
can be caused by tumor near midbrain (pinealoma, meningioma) or cell debris after interventricular hemorrhage, infection. Often called TRIVENTRICULAR HYDROCEPHALUS
Communicating hydrocephalus
low or impaired absorption to the venous system (poorly-developed arachnoid villi, blockage by RBCs or high protein). Could also be from overproduction of CSF, subarachnoid hemorrhage, inflammation.
Hydrocephalus ex vacuo
Due to brain atrophy, little evidence of pressure increase. Larger ventricles, loss of white matter. Not a true hydrocephalus.
Idiopathic intracranial hypertension
Increased intracranial pressure in obese women of childbearing age with little CT/MRI evidence. Headache, tinnitus, pulsatile intracranial noise, visual defects from papilledema. Treatment is weight loss, medication, lumboperitoneal shunting
Normal-pressure hydrocephalus
Elderly with unclear hydrocephalus, elevated pressure and enlarged ventricle characterized by wax and wane of pressure over time –> GAIT DISTURBANCE, URINARY INCONTINENCE, DEMENTIA (characteristic triad). Treatment is shunting.
