Flashcards in Hydrocephalus Deck (40)
What is hydrocephalus?
Excess CSF within the intracranial space & ventricular system causing dilation of the ventricles
Where is the majority of CS produced? How?
Actively via Na pump
How much CSF is produced/ day?
Hoe often does the CSF turnover each day?
Where does the CSF move after leaving the ventricular system?
Where is CSF reabsorbed?
Where does CSF move from the arachnoid villi? How?
What are the 2 major types of hydrocephalus?
What is communicating hydrocephalus also known as?
What is non-communicating also known as?
In CoH, where is the problem observed?
Most commonly due to CSF resorption rather than over production of CSF
What are some of the signs & symptoms observed in CoH?
In infants - increase in head
Nausea & vomiting
6th nerve palsy
Focal neurological deficit
What are some of the causes of CoH?
Infective (bacterial meningitis)
When does NCH occur?
When there is any physical obstruction to normal CSF flow
What are some of the causes of NCH?
What is the earliest imaging evidence of hydrocephalus?
Dilation of the temporal horn of lateral ventricles
What is the treatment for hydrocephalus?
External Ventricular Drain (EVD) - drains the CSF from the ventricular system
What is the mainstay of treatment for CoH?
Shunt placement (Ventriculo-peritoneal shunt)
How can NCH be treated?
Removal of the obstructing lesion
What is one of the downsides of VP shunts?
They can fail, disconnection or cause infection
What is the mneumonic for the classic triad of NPH?
Wet, Wobbly & Wacky
What is one of the reversible causes of dementia?
Normal Pressure Hydrocephalus
What are the symptoms described by Wet Wobbly & Wacky in NPH?
What investigations would you do in CoH?
LP - symptoms improve with CSF removal
What is the treatment for patients with NPH?
VP shunt placement
What are LPs used in the diagnosis of?
Infusion of drugs
What are some contraindications for LP?
Infection at site
What needle helps to reduce spinal shock in LP?
At what level do you perform LP?
What position should the patient lie at?
Lateral Decubitus Position
Which way should the bevel face when performing LP?
Up to keep parallel with nerve/ ligament fibres
What ligament will you pierce when performing LP?
How can you assess opening pressure in LP?
How many vials do you take when doing an LP? What are they for?
1: Culture & gram stain
2: Glucose & protein
3: Cell count & differential
What are some complications of LP?
Bleeding or fluid leak
What is the most common complication of LP?
How can you reduce the complications including spinal headache?
In coning or tonsillar herniation, what are the presenting signs?
Altered mental status
Cranial nerve abnormalities
Cushing triad - bradycardia
How would you manage a patient who presents with coning?
Mannitol or 3% saline