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Flashcards in Hydrocephalus Deck (34):
1

Normal pressure hydrocephalus triad (Hakim's triad)

Difficulty walking/abnormal gait
urinary incontinence
dementia

2

what does the skull contain

brain
blood
CSF

3

what is the normal range of ICP

7-15mmHg

4

pathway of CSF production and circulation

choroid plexus in lateral ventricles
interventricular foramen of monro
3rd ventricle
cerebral aqueduct
4th ventricle
foramen of magendie and luschka
subarachnoid space
arachnoid granulation
dural venous sinuses

5

what is the equation including ICP, MAP + CPP

CPP = MAP - ICP

6

MAP = DBP + _PP

1/3PP

7

does CPP = CBF

no

8

what is Cushing's response

occurs in the case of raised ICP

9

features of Cushing's response

hypertension
bradycardia
irregular breathing

10

over which BP ranges does autoregulation occur

50-150mmHg

11

raised CO2 causes cerebral vasodilatation/constriction

vasodilatation

12

hypo/hyperventilation causes raised CO2

hypoventilation increases CO2

13

low CO2 causes cerebral vasodilatation/constriction

vasoconstriction

14

hypo/hyperventilation causes low CO2

hyperventilation

15

causes of raised ICP

mass effect
oedema
impaired venous outflow
CSF / hydrocephalus

16

signs and symptoms of raised ICP

drowsy
slow
anisocoria (difference in pupil size)
papilloedema
Cushing's response
N+V
hyperthermia

17

supportive management of raised ICP

maintain head in midline
head of bed at 30 degree angle
treat hyperthermia
maintain fluid and electrolyte balance
maintain normocarbia

18

medical management of raised ICP

mannitol, hypertonic saline, furosemide, urea
barbiturate induced coma (last line)
anti epileptic drugs
surgical decompression
remove mass
CSF shunt

19

list types of hydrocephalus

communicating
non-communicating
congenital
acquired
normal pressure

20

what is communicating hydrocephalus

CSF obstruction outwith ventricles
ALL ventricles are enlarged

21

what is non-communicating hydrocephalus

CSF obstruction within ventricular system
enlargement of lateral and 3rd ventricles only
normal 4th ventricle

22

what is a non-communicating hydrocephalus also known as

obstructive hydrocephalus

23

clinical features of obstructive/non-communicating hydrocephalus

swollen head
sunset eyes / upgaze paralysis

24

what is a colloid cyst

benign epitheliated cyst usually located at foramen on monro

25

hydrocephalus ex vacuo is a true hydrocephalus, true or false

false
it is as a result of brain atrophy

26

what is normal pressure hydrocephalus

idiopathic disease of the elderly

27

what is seen on a scan of someone with normal pressure hydrocephalus

large ventricles and large sylvian fissures

28

management of normal pressure hydrocephalus

lumbar drain test
lumbar infusion studies - less done
MoCA and MMSE done before and after lumbar drain for comparison
VP shunt with low pressure valve

29

what is idiopathic intracranial hypertension IIH also known as

pseudotumour cerebri

30

who is affected by IIH

young obese women of child bearing age

31

is there ventricular dilatation in IIH on imaging

no
imaging will look normal

32

signs and symptoms of IIH

debilitating headache
double vision and blurring
pulsatile tinnitus
radicular pain
papilloedema

33

investigations for IIH

LP
CT, MRI
CTV
fundoscopy and ophthalmology

34

management of IIH

weight loss
acetozolamide (carbonic anhydrase inhibitor)
topiramate
diuretics
VP shunt