Flashcards in Neuropathology 3- raised ICP, SOL and trauma Deck (24):
Normal value of intercranial pressure
Five potential causes of raised ICP
Diffuse lesion (e.g. oedema)
Increased venous volume (e.g. obstructed airway, obstructed neck veins)
How do hypoxia and hypercapnia lead to raised ICP?
Arteriolar vasodilatation- increases arterial blood volume within brain
Normal volume and turnover of CSF
120-150ml; turnover of 3-5x per day
Where is CSF produced?
Choroid plexus in the lateral and fourth ventricles
Where is CSF reabsorped?
Into the dural venous sinuses, via arachnoid granulations
Foramen between lateral and third ventricle
Foramen of Monro
How does CSF enter the subarachnoid space?
Via the exit foraminae of Luschka and Magendie
Obstruction to flow of CSF occurring within the ventricular system
Obstruction to flow of CSF occurring outwith the ventricular system (e.g. in subarachnoid space or arachnoid granulations)
Neurological features associated with raised ICP
Reduction in consciousness level
Ipsilateral fixed and dilated pupil
Signs of shift/herniation
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)
Manifestations of subfalcine herniation
Sensory/motor loss in leg due to ischaemia of the sensory/motor cortexes
Manifestations of a tentorial herniation
Ipsilateral dilated pupil, defective eye movements due to third nerve compression
Signs of a tonsillar hernia
Apnoea by compression of respiratory centres
Most common type of malignant primary intercranial tumour
Cancers which commonly metastasize to brain
Bronchus, breast, kidney
Astrocystomas often develop into...
Glioblastoma can be identified by immunohistochemistry against...?
Which has the worst prognosis, primary or secondary glioblastoma?
Primary- mean survival around 5 months
Common symptoms of brain malignancy
Potential causes of a single brain abscess
Usually focal cause- e.g. otitis media, sinusitis, skull fracture, penetrating injury
Potential causes of multiple brain abscesses
Usually result from septicaemia