Neuropathology 3- raised ICP, SOL and trauma Flashcards Preview

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Flashcards in Neuropathology 3- raised ICP, SOL and trauma Deck (24):
1

Normal value of intercranial pressure

5-13mmHg

2

Five potential causes of raised ICP

SOL
Diffuse lesion (e.g. oedema)
Hydrocephalus
Increased venous volume (e.g. obstructed airway, obstructed neck veins)
Hypoxia/hypercapnia

3

How do hypoxia and hypercapnia lead to raised ICP?

Arteriolar vasodilatation- increases arterial blood volume within brain

4

Normal volume and turnover of CSF

120-150ml; turnover of 3-5x per day

5

Where is CSF produced?

Choroid plexus in the lateral and fourth ventricles

6

Where is CSF reabsorped?

Into the dural venous sinuses, via arachnoid granulations

7

Foramen between lateral and third ventricle

Foramen of Monro

8

How does CSF enter the subarachnoid space?

Via the exit foraminae of Luschka and Magendie

9

Obstruction to flow of CSF occurring within the ventricular system

Non-communicating hydrocephalus

10

Communicating hydrocephalus

Obstruction to flow of CSF occurring outwith the ventricular system (e.g. in subarachnoid space or arachnoid granulations)

11

Neurological features associated with raised ICP

Reduction in consciousness level
Ipsilateral fixed and dilated pupil
Papilloedema
Signs of shift/herniation

12

Three most common types of herniation in raised ICP

Subfalcine ( cingulate gyrus under the falx celebri)
Tentorial (temporal lobe herniates through tentorium)
Tonsillar (cerebellar tonsils herniate into the foramen magnum)

13

Manifestations of subfalcine herniation

Sensory/motor loss in leg due to ischaemia of the sensory/motor cortexes

14

Manifestations of a tentorial herniation

Ipsilateral dilated pupil, defective eye movements due to third nerve compression

15

Signs of a tonsillar hernia

Apnoea by compression of respiratory centres

16

Most common type of malignant primary intercranial tumour

Astrocytoma

17

Cancers which commonly metastasize to brain

Bronchus, breast, kidney

18

Astrocystomas often develop into...

Glioblastoma

19

Glioblastoma can be identified by immunohistochemistry against...?

GFAP

20

Which has the worst prognosis, primary or secondary glioblastoma?

Primary- mean survival around 5 months

21

Common symptoms of brain malignancy

Focal symptoms
Headache
Vomiting
Seizures

22

Potential causes of a single brain abscess

Usually focal cause- e.g. otitis media, sinusitis, skull fracture, penetrating injury

23

Potential causes of multiple brain abscesses

Usually result from septicaemia

24

Five aetiologies of cerebral oedema

Vasogenic (blood-brain barrier defect)
Cytotoxic (ischaemic)
Interstitial (hydrocephalus)
Hypo-osmotic (reduced plasma osmolality)
Hydrostatic (increased perfusion pressure)