44 Questions
What is a characteristic of individuals with executive function impairment?
Poor planning and organisation
What is a common symptom of short term memory impairment?
Difficulty following detailed sequence of instructions
What is the meaning of the term 'Hydrocephalus'?
Water in the head
What is a possible consequence of altered concept of time?
No inclination to hurry
What happens when there is a blockage in the circulation of CSF from spaces within the brain?
The ventricles expand and put pressure on the brain
What is a common symptom of blocked shunt?
Loss of appetite
What is the critical point of cerebral mantle thickness below which hydrocephalus becomes untreatable?
1 cm
What is the term for the condition where the lower part of the brain goes further down the spinal cord than usual?
Arnold Chiari Malformation
What is a characteristic of individuals with short attention span?
Difficulty keeping to task
What is non-communicating hydrocephalus characterized by?
A blockage in the flow of CSF
What is a possible treatment option for hydrocephalus?
Surgery only
What is the main function of CSF?
To provide nutrients to the brain and spinal cord
Which of the following is a cause of non-communicating hydrocephalus?
All of the above
What is the composition of CSF?
Water, salt, glucose, and cells
What is the primary function of cerebrospinal fluid in relation to the brain and spinal cord?
To act as a shock absorber between the skull and brain, and between the spinal cord and the spine
What percentage of cerebrospinal fluid is produced by the choroid plexus?
50-80%
What is the primary site of cerebrospinal fluid absorption?
Sagittal sinus
What is a common symptom of hydrocephalus in infants?
Vomiting
What is the term for the prominent forehead seen in children with hydrocephalus?
Frontal bossing
What is a common long-term effect of hydrocephalus in children with spina bifida?
Learning problems and difficulty concentrating
What is a common difficulty experienced by children with spina bifida and hydrocephalus?
Difficulty with fine motor skills
What is a common complication of hydrocephalus in children with spina bifida?
Epilepsy
What percentage of cerebrospinal fluid is produced by a process other than the choroid plexus?
20-50%
What is the primary location of cerebrospinal fluid absorption?
Sagittal sinus
What is the primary reason for the expansion of ventricles in paediatric hydrocephalus?
Blockage in the circulation of CSF from the ventricles
What is a common physical characteristic of children with hydrocephalus?
Large head size
What is the significance of the 'point of no return' in paediatric hydrocephalus?
It is the point beyond which treatment is no longer effective
What is a common cognitive difficulty experienced by children with spina bifida and hydrocephalus?
Impaired spatial awareness
What is the primary cause of communicating hydrocephalus?
Overproduction of CSF
What is the term for the 'soft spots' found on the top of an infant's head?
Fontanelles
What is the term for the condition characterized by excess cerebrospinal fluid in the brain?
Hydrocephalus
What is the role of CSF in the brain and spinal cord?
It provides nutrients to the brain and spinal cord
What is the characteristic of non-communicating hydrocephalus?
There is a blockage in the flow of CSF
What is the role of cerebrospinal fluid in relation to the brain and spinal cord?
To act as a shock absorber
What is a common complication of hydrocephalus in children with spina bifida?
Vision problems
What is the term for the condition where the lower part of the brain goes further down the spinal cord than usual?
Arnold Chiari Malformation
What is the composition of CSF?
Water, salt, glucose, and cells
What is the critical point of cerebral mantle thickness below which hydrocephalus becomes untreatable?
1 cm
What is a characteristic of individuals with executive function impairment?
Difficulty following detailed sequence of instructions
What is a possible cause of experiencing difficulty with comprehension?
Difficulty following detailed sequence of instructions
What is a possible symptom of hydrocephalus in infants?
Bulging fontanelle and increasing head size
What is a possible treatment option for hydrocephalus?
All of the above
What is a characteristic of individuals with short attention span?
Difficulty keeping to task and daydreaming
What is a possible symptom of blocked shunt?
All of the above
Study Notes
Definition of Hydrocephalus
- Hydrocephalus occurs when there is a blockage in the circulation of CSF from spaces within the brain (ventricles) out over the surface of the brain and down the spinal cord.
- When too much CSF gets trapped in the pathway, the ventricles expand and put pressure on the brain.
Aetiology-Based Classification
- Primary (Brain Malformation): Dysgenetic (Focal - Aqueductal Stenosis, Global - Holoprosencephaly)
- Secondary: Trauma, Aneurysmal Subarachnoid Haemorrhage, Infection, Tumour
Classification
- Communicating Hydrocephalus: occurs when more CSF is produced than can be reabsorbed (e.g. meningitis, traumatic brain injury)
- Non-Communicating Hydrocephalus: blockage in the flow of CSF (e.g. spina bifida, tumours, meningitis)
CSF
- CSF is a clear, colourless fluid that provides nutrients to the brain and spinal cord and takes away waste products.
- It acts as a shock absorber between the skull and the brain, and between the spinal cord and the spine.
CSF Production and Absorption
- 50-80% of CSF is produced by the Choroid Plexus through an energy-dependent process.
- 20-50% is a by-product of CNS metabolism.
- Primary site of absorption is the Sagittal Sinus, through a passive process.
Symptoms
- High-pitched cry, poor feeding, vomiting, large head, full and hard fontanelles.
- Headache, lethargy, and sunset eyes (where the white of the eye can be seen at the top of the eye).
Signs
- Large head size or rapidly growing head.
- Full fontanelles ('soft spot') in a baby.
- 'Sunset eyes' and frontal bossing (the forehead more prominent).
Long-term Effects
- Children with spina bifida may have physical problems, learning difficulties, and difficulty concentrating.
- Some may have vision problems, epilepsy, headaches, and early onset of puberty.
- Fine motor skills may be impaired, affecting drawing and sports.
- Short-term memory impairment, short attention span, and diminished motivation/initiation.
Management
- Drainage, surgery, and medication.
- Third ventriculostomy and shunt management (with potential complications of blocked shunt).
Definition of Hydrocephalus
- Hydrocephalus occurs when there is a blockage in the circulation of CSF from spaces within the brain (ventricles) out over the surface of the brain and down the spinal cord.
- When too much CSF gets trapped in the pathway, the ventricles expand and put pressure on the brain.
Aetiology-Based Classification
- Primary (Brain Malformation): Dysgenetic (Focal - Aqueductal Stenosis, Global - Holoprosencephaly)
- Secondary: Trauma, Aneurysmal Subarachnoid Haemorrhage, Infection, Tumour
Classification
- Communicating Hydrocephalus: occurs when more CSF is produced than can be reabsorbed (e.g. meningitis, traumatic brain injury)
- Non-Communicating Hydrocephalus: blockage in the flow of CSF (e.g. spina bifida, tumours, meningitis)
CSF
- CSF is a clear, colourless fluid that provides nutrients to the brain and spinal cord and takes away waste products.
- It acts as a shock absorber between the skull and the brain, and between the spinal cord and the spine.
CSF Production and Absorption
- 50-80% of CSF is produced by the Choroid Plexus through an energy-dependent process.
- 20-50% is a by-product of CNS metabolism.
- Primary site of absorption is the Sagittal Sinus, through a passive process.
Symptoms
- High-pitched cry, poor feeding, vomiting, large head, full and hard fontanelles.
- Headache, lethargy, and sunset eyes (where the white of the eye can be seen at the top of the eye).
Signs
- Large head size or rapidly growing head.
- Full fontanelles ('soft spot') in a baby.
- 'Sunset eyes' and frontal bossing (the forehead more prominent).
Long-term Effects
- Children with spina bifida may have physical problems, learning difficulties, and difficulty concentrating.
- Some may have vision problems, epilepsy, headaches, and early onset of puberty.
- Fine motor skills may be impaired, affecting drawing and sports.
- Short-term memory impairment, short attention span, and diminished motivation/initiation.
Management
- Drainage, surgery, and medication.
- Third ventriculostomy and shunt management (with potential complications of blocked shunt).
Learn about the definition and causes of hydrocephalus, including primary and secondary aetiology-based classification.
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