Clinical Correlations: Cranium, Meninges and Ventricles PDF

CLINICAL CORRELATIONS: CRANIUM, MENINGES AND VENTRICLES BIO336 Audrey Forbes-Cardinali, D.C. Mercyhurst University  INTRACRANIAL MASS Anything that takes up space in the cranial vault Hydrocephalus, tumor, hemorrhage, abscess, edema, etc. Intracranial...

CLINICAL CORRELATIONS: CRANIUM, MENINGES AND VENTRICLES BIO336 Audrey Forbes-Cardinali, D.C. Mercyhurst University  INTRACRANIAL MASS Anything that takes up space in the cranial vault Hydrocephalus, tumor, hemorrhage, abscess, edema, etc. Intracranial masses can cause local tissue compression/damage (Mass effect) S/Sx will be consistent with area of damage Can increase intracranial pressure Could also cause a midline shift or herniation Part of CNS gets shifted to another compartment HERNIATION  I N T R AC R A N I A L PRESSURE Compensated – small lesion can cause decrease in CSF or blood volume Uncompensated – large lesion, ICP increases S/Sx: Headache, Nausea,Vomiting, Altered Mental status, Visual loss, Papilledema  PAPILLEDEMA Jonathan Trobe, M.D. University of Michigan Kellogg Eye Center INTRACRANIAL HEMORRAGE  INTRACRANIAL HEMORRHAGE Epidural hematoma Subdural hematoma Acute (High velocity impact) or Chronic (Low/no trauma) Subarachnoid hematoma Nontraumatic or Traumatic Intracerebral hematoma Trauma (Coup/Contrecoup), hypertensive hemorrhage, vascular malformations S U B A R AC H N O I D H E M O R R H AG E Nontraumatic is generally dissection of an aneurysm “Worst headache of my life” Traumatic is due to brain contusion/trauma leading to ruptured vessels  H Y D RO C E P H A L U S Causes are 1. excess CSF production 2. obstruction of flow at any point in the ventricles or subarachnoid space 3. decrease in reabsorption via the arachnoid granulations. Different outcomes in neonates/toddlers than adults HYDROCEPHALUS  CRANIOTOMY Burr holes are drilled without piercing dura and bone between the holes is cut with a saw. Bone flap Dura can be carefully cut so surgery is performed Flap is saved so it can be replaced later Image accessed from https://meetingarchive.ami.org/2021/project/joseph-smith-right-frontoparietal- craniotomy-subdural-hematoma-evacuation-and-reconstruction/