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3 Neurology > CSF Disorders > Flashcards

CSF Disorders Flashcards

1
Q

you shouldn’t drain more than __ml of CSF in a lumbar puncture

A

30

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2
Q

upper limit of normal for CSF pressure?

A

15mmHg

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3
Q

a CSF pressure of >__mmHg is abnormally high

A

20

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4
Q

average CSF pressure is __mmHg

A

10

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5
Q

how much CSF is made and absorbed per day?

A

a pint

a pint

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6
Q

what drug is very effective at reducing ICP

A

acetazolamide

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7
Q

absorption of CSF is driven by….

A

ICP

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8
Q

physical functions of CSF?

A

buoyancy

accompanies physical changes in the head

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9
Q

weight of the brain is…

A

1.5kg

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10
Q

fluid trapped in spinal cord is called…

A

syringomyelia

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11
Q

a child with hydrocephalus from birth’s phenotype is..

A

an unusually large head
thin shiny scalp with visible veins
bulging fontanelle
downward looking eyes

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12
Q

babies with hydrocephalus will have what problems?

A 
poor feeding
irritability
vomiting
sleepiness
muscle stiffness and spasm in lower limbs
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13
Q

2 types of hydrocephalus?

A

obstructive

communicating

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14
Q

why do you get papilloedema?

A

optic nerve is an extension of the CNS and has meninges around it thus contains CSF

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15
Q

acquired causes of paediatric hydrocephalus?

A

haemorrhage
infection ie post meningitis
trauma
tumour

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16
Q

a child with congenital hydrocephalus will have it for life T or F

A

T

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17
Q

how can subarachnoid haemorrhages cause hydrocephalus?

A

the blood blocks up the arachnoid granulations

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18
Q

shunt complications?

A 
overdrainage
underdrainage = blockage
infection
seizures
intracerebral haemorrhage
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19
Q

symptoms of a blocked shunt?

A

headache
vomiting
lack of upgaze in adults
papilloedema

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20
Q

Ix and Tx of a blocked shunt

A

CSF sample to microbiology

CT head

21
Q

name the triad that presents in normal pressure hydrocephalus?

A

ataxia
memory decline
incontinence
(basically get dementia)

22
Q

causes of NPH

A 
idiopathic
SAH (subarachnoid haemorrhage)
meningitis
trauma
craniotomy
23
Q

what does the ataxia in NPH present like?

A

a broad based, shuffling gait

24
Q

Ix of NPH

A

CT/MRI
tracer diffusion studies
ICP measurement
tap test lumbar puncture

25
Q

Tx of NPH

A

VP shunt

26
Q

who gets IIH?

A

young overweight females

27
Q

what conditions are associated with IIH?

A 
obesity
sleep aponoea
hypothyroid
addisons
lupus
28
Q

symptoms of IIH

A

headaches

visual field loss from papilloedema

29
Q

signs of IIH ?

A

papilloedema
constricted visual fields
loss of visual acuity

30
Q

LP pressure of someone with IIH would be…

A

> 25mmHg (HIGH)

31
Q

IIH is normal on imaging T or F

A

T

32
Q

Tx of IIH

A 
treat underlying cause
diuretics
lumbar puncture
VP/LP (lumbar-peritoneal) shunt
weight loss
33
Q

LP shunt complications

A

blockage
infection
nerve root irritation
subdural haemorrhage

34
Q

what is an orthostatic headache?

A

a headache present on standing up that is relieved when lying down

35
Q

symptoms of SIH

A 
orthostatic headaches
neck/upper back/arm pain
visual field defects
dizziness
muffled hearing
36
Q

in IIH the ventricles are normal size T or F

A

T

37
Q

causes of SIH

A

idiopathic
collagen disorders
dural diverticula (looks really thick)
trauma

38
Q

“fat girl off school for years with headaches and has papilloedema” could be…

A

IIH

39
Q

SIH Tx

A

conservative

surgery

40
Q

drug Tx of mild IIH

A

acetazolamide

diuretic

41
Q

SIH Ix

A

MRI

lumbar puncture

42
Q

syringomyelia classic presentation?

A 
sensory loss - cant feel pain
loss of limb reflexes
involuntary movements
muscle wasting
clawed hands
43
Q

in a patient with persisting spine and limb symptoms ___ should always be considered

A

syringomyelia

44
Q

early features of syringomyelia?

A

hyperhidrosis

45
Q

hindbrain hernias are a form of…

A

syringomyelia

46
Q

main symptoms of a hindbrain hernia

A

headaches following valsalva
visual disturbances
ear disturbance
sometimes papilloedema

47
Q

sleep apnoea is a common problem in those with…

A

hindbrain hernias

48
Q

syringomyelia Tx

A

open up CSF channels via craniovertebral decompression
drain syrinx cavity
lower CSF pressure

49
Q

where can CSF fluid be diverted to if there is too much in the subarachnoid space?

A

pleural cavity

peritoneal cavity

3 Neurology (41 decks)

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