22 Questions
What percentage of CSF is produced by the choroid plexus?
50-80%
What is the primary site of CSF absorption?
Sagittal sinus
What is a symptom of hydrocephalus in infants?
Vomiting
What is a long-term effect of hydrocephalus on cognitive function?
Some learning problems and difficulty concentrating
What is a sign of hydrocephalus in infants?
Full fontanelles
What does the term 'hydrocephalus' literally mean?
Water in the head
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
What is a common physical problem associated with spina bifida?
Paralysis
What is a common challenge for individuals with spina bifida and hydrocephalus?
Impaired fine motor skills
According to Rosseau et al (1992), what is the critical cerebral mantle thickness below which treatment may not be effective?
1 cm
Which of the following is an example of primary brain malformation leading to hydrocephalus?
Holoprosencephaly
What is a possible effect of hydrocephalus on the eyes?
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
Which type of hydrocephalus occurs when there is a blockage in the flow of CSF?
Non-communicating hydrocephalus
What is the primary function of CSF?
Providing nutrients to the brain and spinal cord and removing waste products
What can be a cause of communicating hydrocephalus?
All of the above
What is a common symptom of short term memory impairment?
Difficulty following detailed sequence of instructions
What is a characteristic of diminished motivation/initiation?
Sitting and waiting for instructions
What is a possible consequence of a blocked shunt?
Seizures (fits)
What is a characteristic of executive functions impairment?
Not thinking before acting, poor planning and organization
What is a possible symptom of altered concept of time?
No inclination to hurry
What is a possible treatment for the condition mentioned in the content?
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).
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.
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