Ventricular system, CSF, clinical relevance

Question 1

Where is majority of CSF produced?

Answer 1

In the choroid process of the lateral ventricles

Question 2

What must CSF pass in order to enter the 3rd ventricle?

Answer 2

The interventricular foramen

Question 3

What must CSF pass in order to enter the 4th ventricle?

Answer 3

The cerebral aqueduct

Question 4

What structures are responsible of CSF resorption into venous drainage?

Answer 4

The arachnoid villi

Question 5

Where can the arachnoid villi be found?

Answer 5

On the sagittal sinus

Question 6

What is the condition called that is a result of blockage of CSF flow in the ventricles?

Answer 6

hydrocephalus

Question 7

Describe the pathogenesis of hydrocephalus?

Answer 7

Rise in fluid pressure causing the ventricles to swell = raised intracranial pressure

Question 8

Give 3 symptoms of hydrocephalus?

Answer 8

headache
unsteadiness
mental impairment

Question 9

How can pressure be relieved in hydrocephalus?

Answer 9

Insertion of a shunt connecting the ventricular system to the jugular vein

Question 10

Describe the pathology of venous sinus thrombosis?

Answer 10

Obstruction of venous drainage which causes cerebral oedema and raised inter-cranial pressure

Question 11

What symptoms might you except as a result of brain damage in venous sinus thrombosis

Answer 11

Headache
epileptic seizures
focal motor deficit
deterioration of consciousness

Question 12

What are the 4 types of hamoerrhages you can get in the brain?

Answer 12

Extradural
subdural
subarachnoid
intercerebral

Question 13

Where does an extradural haemorrhage take place

Answer 13

Between the skull and the dura mater

Question 14

What accident is most likely to result in a extradural haemorrhage?

Answer 14

head injury

Question 15

What happens in a extradural haemorrhage?

Answer 15

Strips the dura of the skull and compresses the brain

Question 16

Where does a extradural haemorrhage result from?

Answer 16

Haemorrhage of the meningeal arteries

Question 17

Where does a subdural haemorrhage take place?

Answer 17

presence of blood between the dura and arachnoid layers

Question 18

What accident is likely to result in a subdural haemorrhage

Answer 18

Road traffic accident

Question 19

What vessels tears in a subdural heamorrhage?

Answer 19

Tears in the bridging veins

Question 20

What kind of a bleed is a subdural haemorrhage and why?

Answer 20

a venous bleed with low pressure

slow and gradual bleed

Question 21

Where does a subarachnoid haemorrhage take place?

Answer 21

Blood between the arachnoid and pia mater

Question 22

What is likely to cause a subarachnoid haemorrhage?

Answer 22

A traumatic subarachnoid haemorrhage or a berry aneurysm

Question 23

What is a pathological symptom of a subarachnoid haemorrhage?

Answer 23

Sudden severe headache

syncope

Question 24

Where does an inter-cerebral haemorrhage occur?

Answer 24

Rupture of the small vessels in perforating vessels that lead to bleeding within brain tissue

Question 25

Give a common site for intercerebral haemorrhages to occur?

Answer 25

Internal capsule following rupture due to high blood pressure

Question 26

What is meningitis?

Answer 26

Inflammation of the meninges typically caused by infection

Question 27

What is the meningism triad?

Answer 27

Headache stiff neck photophobia

Question 28

What other symptoms (not the trida) may also be present in meningitis?

Answer 28

Nausea and vomiting | fever

Question 29

Why is bacterial meningitis more urgent and requires urgent treatment?

Answer 29

It can lead to brain damage or death

Question 30

What is amaurosis fugax?

Answer 30

Temporary vision loss in one eye

Question 31

What happens in amaurosis fugax?

Answer 31

Part of a carotid plaques breaks off and occludes the retinal artery

Question 32

What is a berry aneurysm?

Answer 32

Congenital sac like pouching of an inter-craninal artery

Question 33

What happens in the berry aneurysm?

Answer 33

Progressive enlargement of the sac like pouching until sudden rupture resulting in subarachnoid/inter cerebral haemorrhage

Question 34

where is berry aneurysm most likely to occur?

Answer 34

Branching points around the circle of willis Commonly the anterior communicating artery which lies in the subarachnoid space

Question 35

What are the 2 types of stroke?

Answer 35

Ischaemic or haemorrhagic

Question 36

Where does an ischaemic stroke occur?

Answer 36

Intercerebral haemorrhage bleeding into the brain tissue

Question 37

Where is a haemorrhagic stroke occur?

Answer 37

A subarachnoid haemorrhage between the arachnoid and pia mater