Flashcards in CSF, Hydrocephalus and Lumbar Puncture Deck (16)
Where is CSF found?
Where is the choroid plexus located?
Floor of lateral ventricles
What is the aetiology of hydrocephalus?
Dandy- Walker malformation
Benign or malignant neoplasia
What are the symptoms of hydrocephalus in infants?
Splaying of cranial sutures
Engorged scalp veins
Fontanelles full and bulging
What are the symptoms of hydrocephalus in older children and adults?
Headaches worse in morning and on coughing
Loss of upgaze or abducens palsy
What is the treatment for hydrocephalus ?
Acetazolamide (carbonic anhydrase inhibitor)
External ventricular drain (emergency)
CSF diversion with shunt
What are the complications of shunting?
Over drainage (low pressure headaches, subdural haematoma)
Distal end problems (abdominal hernias, cardiac arrhythmias)
What is an endoscopic ventriculostomy?
Fistula created between 3rd ventricle and subarachnoid spaces/ basal cisterns
What are the clinical features of non pressure hydrocephalus?
Dementia (potentially reversible)
What are the clinical features of idiopathic intracranial hypertension?
Headaches and visual disturbance
What is the treatment of idiopathic intracranial hydrocephalus?
CSF diversion -VP or LP shunt
Optic nerve sheath fenestration
What are the indications for lumbar puncture?
Obtain CSF for analysis
Measurement of pressure
CSF drainage for raised pressure
Diagnostic test for normal pressure hydrocephalus
What is checked before a lumbar puncture?
Awake and conscious patient
No focal neurological deficit (6th nerve palsy)
CT/MRI (rule out intracranial mass lesion)
Ensure patients not on anticoagulants
What are the risks of a lumbar puncture?
Nerve root injury
Retroperitoneal/ intraabdominal injury
How would CSF indicate meningitis?
Lots of WBC