Ventricular system and CSF

Question 1

Where does the choroid plexus develop from?

Answer 1

The choroid plexus develops from cells in the walls of the ventricles

Question 2

Developing arteries invaginate the roof of the ventricle to form the …?

Answer 2

Choroid fissure

Question 3

The involuted ependymal cells along with the vessels enlarge into villi and form the…?

Answer 3

Choroid plexus

Question 4

Where is the choroidal plexus found in the adult brain?

Answer 4

It is found in the 3rd, 4th and lateral ventricles

Question 5

What restricts the majority of the blood supply to the brain?

Answer 5

The BBB

Question 6

Sites of the brain without BBB

Answer 6

circumventricular organs or pineal glandv

Question 7

CSF rate of formation

Answer 7

CSF formation at a rate of ∼0.4 ml·min−1·g tissue−1 (similar to proximal renal tubule and pancreatic ducts); 500-600ml / day
Total amount of CSF in CNS amounts to 150ml and is replaced 3-4 x daily

Question 8

What do “routine CSF parameters” include?

Answer 8

include protein, albumin, immunoglobulin, glucose, lactate, and cellular changes, as well as specific antigen and antibody testing for infectious agents

Question 9

Normal CSF

Answer 9

Normal CSF is clear and colorless, contains little protein (15-45mg/dl), little immunoglobulins and only 1-5 cells/ml

Question 10

Pinealoma

Answer 10

(arising from the pineal gland in the midbrain and often compressing the cerebral aqueduct)

Question 11

Colloid cyst

Answer 11

rare glioma type, often found at the interventricular formamen

Question 12

Ependymoma

Answer 12

5% of all gliomas, arising from the ependymal cells lining the ventricles; predilection for posterior fossa; predominantly found in children < 5 yrs)

Question 13

Dementia, incontinence and gait disturbances

Answer 13

Normal pressure hydrocephalus

Question 14

Idiopathic intracranial hypertension / pseudotumor cerebri

Answer 14

igmatic condition mostly seen in obese females of childbearing age
Symptoms include headache and visual disturbances (visual field disturbances to blindness) due to papilloaedema
Despite increased CSF pressure (raised opening pressure on lumbar puncture > 25cmH2O; normal 10-20) no imaging features of hydrocephalus
Management with weight loss, medication and potentially ventriculoperitoneal shunt

Question 15

Enlarged blind spot?

Answer 15

Papilloedema

Question 16

Bulging optic disc seen in opthalmoscope?

Answer 16

Papilloedema

Question 17

Where is the canal of schlemm?

Answer 17

The iridocorneal angle