Ventricular system, CSF, clinical relevance Flashcards
Where is majority of CSF produced?
In the choroid process of the lateral ventricles
What must CSF pass in order to enter the 3rd ventricle?
The interventricular foramen
What must CSF pass in order to enter the 4th ventricle?
The cerebral aqueduct
What structures are responsible of CSF resorption into venous drainage?
The arachnoid villi
Where can the arachnoid villi be found?
On the sagittal sinus
What is the condition called that is a result of blockage of CSF flow in the ventricles?
hydrocephalus
Describe the pathogenesis of hydrocephalus?
Rise in fluid pressure causing the ventricles to swell = raised intracranial pressure
Give 3 symptoms of hydrocephalus?
headache
unsteadiness
mental impairment
How can pressure be relieved in hydrocephalus?
Insertion of a shunt connecting the ventricular system to the jugular vein
Describe the pathology of venous sinus thrombosis?
Obstruction of venous drainage which causes cerebral oedema and raised inter-cranial pressure
What symptoms might you except as a result of brain damage in venous sinus thrombosis
Headache
epileptic seizures
focal motor deficit
deterioration of consciousness
What are the 4 types of hamoerrhages you can get in the brain?
Extradural
subdural
subarachnoid
intercerebral
Where does an extradural haemorrhage take place
Between the skull and the dura mater
What accident is most likely to result in a extradural haemorrhage?
head injury
What happens in a extradural haemorrhage?
Strips the dura of the skull and compresses the brain
Where does a extradural haemorrhage result from?
Haemorrhage of the meningeal arteries
Where does a subdural haemorrhage take place?
presence of blood between the dura and arachnoid layers
What accident is likely to result in a subdural haemorrhage
Road traffic accident
What vessels tears in a subdural heamorrhage?
Tears in the bridging veins
What kind of a bleed is a subdural haemorrhage and why?
a venous bleed with low pressure
slow and gradual bleed
Where does a subarachnoid haemorrhage take place?
Blood between the arachnoid and pia mater
What is likely to cause a subarachnoid haemorrhage?
A traumatic subarachnoid haemorrhage or a berry aneurysm
What is a pathological symptom of a subarachnoid haemorrhage?
Sudden severe headache
syncope
Where does an inter-cerebral haemorrhage occur?
Rupture of the small vessels in perforating vessels that lead to bleeding within brain tissue
Give a common site for intercerebral haemorrhages to occur?
Internal capsule following rupture due to high blood pressure
What is meningitis?
Inflammation of the meninges typically caused by infection
What is the meningism triad?
Headache
stiff neck
photophobia
What other symptoms (not the trida) may also be present in meningitis?
Nausea and vomiting
fever
Why is bacterial meningitis more urgent and requires urgent treatment?
It can lead to brain damage or death
What is amaurosis fugax?
Temporary vision loss in one eye
What happens in amaurosis fugax?
Part of a carotid plaques breaks off and occludes the retinal artery
What is a berry aneurysm?
Congenital sac like pouching of an inter-craninal artery
What happens in the berry aneurysm?
Progressive enlargement of the sac like pouching until sudden rupture resulting in subarachnoid/inter cerebral haemorrhage
where is berry aneurysm most likely to occur?
Branching points around the circle of willis
Commonly the anterior communicating artery which lies in the subarachnoid space
What are the 2 types of stroke?
Ischaemic or haemorrhagic
Where does an ischaemic stroke occur?
Intercerebral haemorrhage
bleeding into the brain tissue
Where is a haemorrhagic stroke occur?
A subarachnoid haemorrhage
between the arachnoid and pia mater
