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Flashcards in Neu 11 - CSF Deck (24):
1

Which is the CSF circulation?

Lateral ventricles. Third ventricle. Cerebral aqueduct. Fourth ventricle.

2

Where is the CSF come from?

Choroid plexus of lateral ventricle.

3

Which structure communicates lateral ventricles and third ventricle?

Foramen of Monro.

4

Which structure communicates third ventricle and fourth ventricle?

Cerebral aqueduct (of Sylvius).

5

Which are the name of the structures that communicate fourth ventricle to subarachnoid space?

1)Foramina of Luschka = Lateral. 2)Foramina of Magendie = Medial.

6

Where is reabsorbed the CSF?

It is reabsorbed by arachnoid granulation and then drains into dural venous sinuses.

7

Which are the structures into the Carotid sheath?

1)Internal jugular vein. 2)Common carotid artery. 3)Vagus nerve.

8

What is the definition of a Noncommunicating hydrocephalus?

Caused by structural blockage of CSF circulation within ventricular system (e.g., stenosis of aqueduct of Sylvius; colloid cyst blocking foramen of Monro).

9

Which are the possibles consequences of a Noncommunicating hydrocephalus?

Headache, Papilledema, Uncalled herniation (eye down and out) and Death.

10

Which are the characteristics of the communicating hydrocephalus?

1)Poor reabsorption of CSF at the arachnoid granulations. 2)Increased Intracranial Pressure. 3)Headache. 4)Papilledema. 5)Herniation.

11

Urinary incontinence, Dementia, and ataxia are symptoms of what?

Triad of the Normal pressure hydrocephalus. "Wet" "wacky" and "wobbly".

12

What is the pathology characterized by affects the elderly, CSF pressure elevated only episodically, expansion of ventricle sand distorts the fibers of the corona radiata?

Normal pressure hydrocephalus.

13

What is the hydrocephalus ex vacuo?

Atrophied brain tissue around the ventricles, and ventricles appear enlarged by comparison.

14

In which patients can we see an hydrocephalus ex vacuo?

Patients with Alzheimer disease, advanced HIV, pick disease. And Triad is not seen.

15

What are the characteristic features in pseudotumor cerebri?

1)Young, obese woman. 2)Headache -daily (worse in the morning) pulsatile, possible nausea/vomiting, possible retroocular pain worsened by eye movement. 3)Papilledema. 4)CSF pressure elevated (greater than 200 mmHg in non-obese, greater than 250mmHg in obese patient).

16

What is the most worrisome sequels of the pseudotumor cerebri?

It is vision loss.

17

What can we see on the CT scan in a patient with pseudotumor cerebri?

Absence of ventricular dilation, no tumor or mass.

18

What treatment options are available for managing pseudotumor cerebri?

1)Confirm absence of other pathology its CT and MRI of the head . 2)Discontinue any inciting agents(e.g., Vit. A, tetracyclines, corticosteroid withdrawal). 3)Weight loss in obese patients. 4)Acetazolamide - First line(Start 250mg qid or 500mg bid -> increase to 500mg qid to 1000mg qid). 5)Invasive treatment options: serial lumbar puncture, optic nerve sheath decompression and lumboperitoneal shunting (CSF shunt).

19

What does CFS means?

CerebroSpinal Fluid

20

Where is CSF generated?

Choroid plexus

21

Where is CSF reabsorbed?

Arachnoid granulations (superior Sagittal sinus)

22

What is the difference between communicating and Noncommunicating hydrocephalus?

Communicating hydrocephalus: Decreased absorption of CSF. Noncommunicating hydrocephalus: Physical obstruction.

23

What clinical features characterized normal pressure hydrocephalus?

Triad: 1)Urinary incontinence. 2)Dementia. 3)Ataxia.

24

What are the 3W's of normal pressure hydrocephalus?

Wet, wacky, and wobbly. For urinary incontinence, Dementia and ataxia.