Paediatric Hydrocephalus
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Questions and Answers

What percentage of CSF is produced by the choroid plexus?

  • 10-20%
  • 50-80% (correct)
  • 20-30%
  • 30-50%
  • What is the primary site of CSF absorption?

  • Sagittal sinus (correct)
  • Choroid plexus
  • Spinal cord
  • Ventricles
  • What is the pressure gradient between the CSAS and SSS?

  • 5-7 mm Hg (correct)
  • 20-25 mm Hg
  • 10-15 mm Hg
  • 15-20 mm Hg
  • What is a common symptom of hydrocephalus in babies?

    <p>All of the above</p> Signup and view all the answers

    What is a long-term effect of hydrocephalus in children with spina bifida?

    <p>All of the above</p> Signup and view all the answers

    What is a common physical problem in children with spina bifida?

    <p>All of the above</p> Signup and view all the answers

    What is a sign of hydrocephalus in babies?

    <p>All of the above</p> Signup and view all the answers

    What is a common effect of hydrocephalus on daily life?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the lower part of the brain going further down the spinal cord than usual?

    <p>Arnold Chiari Malformation</p> Signup and view all the answers

    What is the primary function of CSF?

    <p>To provide nutrients to the brain and spinal cord and take away waste products</p> Signup and view all the answers

    What is the consequence of delayed treatment in severe hydrocephalus?

    <p>A point of no return will be reached</p> Signup and view all the answers

    Which of the following is an example of secondary hydrocephalus?

    <p>Aneurysmal Subarachnoid Haemorrhage</p> Signup and view all the answers

    What is the minimum thickness of the cerebral mantle required for treatability?

    <p>1 cm</p> Signup and view all the answers

    What is the term for hydrocephalus caused by overproduction of CSF or inability to reabsorb it?

    <p>Communicating hydrocephalus</p> Signup and view all the answers

    What is the composition of CSF?

    <p>Water, salt, glucose, and cells</p> Signup and view all the answers

    What is the term for hydrocephalus caused by a blockage in the flow of CSF?

    <p>Non-communicating hydrocephalus</p> Signup and view all the answers

    What is a characteristic of Executive Functions in individuals with Short Term Memory Impairment?

    <p>Not thinking before acting, poor planning and organisation</p> Signup and view all the answers

    What is a common symptom of a blocked shunt in individuals with Short Term Memory Impairment?

    <p>Vomiting or loss of appetite</p> Signup and view all the answers

    Which of the following is NOT a characteristic of individuals with Short Term Memory Impairment?

    <p>Increased motivation and initiation</p> Signup and view all the answers

    What is a potential consequence of Altered Concept of Time in individuals with Short Term Memory Impairment?

    <p>No inclination to hurry</p> Signup and view all the answers

    What is a characteristic of Inability to Generalise in individuals with Short Term Memory Impairment?

    <p>Difficulty transferring concepts from one situation to another, especially in mathematics</p> Signup and view all the answers

    What is a common symptom of Short Term Memory Impairment in infants?

    <p>Bulging fontanelle and increasing head size</p> 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 in children, including the blockage of CSF circulation and its impact on the brain.

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