Paediatric Hydrocephalus

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Questions and Answers

What percentage of CSF is produced by the choroid plexus?

50-80% (correct)

20-30%

10-20%

30-50%

What is the primary site of CSF absorption?

Cerebral cortex

Ventricles

Sagittal sinus (correct)

Brain stem

What is a symptom of hydrocephalus in infants?

Small head size

Increased appetite

Rapid weight loss

Vomiting (correct)

What is a long-term effect of hydrocephalus on cognitive function?

Some learning problems and difficulty concentrating Signup and view all the answers

What is a sign of hydrocephalus in infants?

Full fontanelles Signup and view all the answers

What does the term 'hydrocephalus' literally mean?

Water in the head Signup and view all the answers

What is the result of a blockage in the circulation of CSF from spaces within the brain?

Trapped CSF in the pathway, expanding ventricles and putting pressure on the brain Signup and view all the answers

What is a common physical problem associated with spina bifida?

Paralysis Signup and view all the answers

What is a common challenge for individuals with spina bifida and hydrocephalus?

Impaired fine motor skills Signup and view all the answers

According to Rosseau et al (1992), what is the critical cerebral mantle thickness below which treatment may not be effective?

1 cm Signup and view all the answers

Which of the following is an example of primary brain malformation leading to hydrocephalus?

Holoprosencephaly Signup and view all the answers

What is a possible effect of hydrocephalus on the eyes?

Vision problems Signup and view all the answers

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 Signup and view all the answers

Which type of hydrocephalus occurs when there is a blockage in the flow of CSF?

Non-communicating hydrocephalus Signup and view all the answers

What is the primary function of CSF?

Providing nutrients to the brain and spinal cord and removing waste products Signup and view all the answers

What can be a cause of communicating hydrocephalus?

All of the above Signup and view all the answers

What is a common symptom of short term memory impairment?

Difficulty following detailed sequence of instructions Signup and view all the answers

What is a characteristic of diminished motivation/initiation?

Sitting and waiting for instructions Signup and view all the answers

What is a possible consequence of a blocked shunt?

Seizures (fits) Signup and view all the answers

What is a characteristic of executive functions impairment?

Not thinking before acting, poor planning and organization Signup and view all the answers

What is a possible symptom of altered concept of time?

No inclination to hurry Signup and view all the answers

What is a possible treatment for the condition mentioned in the content?

All of the above Signup and view all the answers

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).

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Description

This quiz covers the definition and effects of hydrocephalus, a condition where there is a blockage in the circulation of cerebrospinal fluid (CSF) in the brain.