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33 Cards in this Set
- Front
- Back
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Causes of normal pressure hydrocephalus |
Can occur idiopathically or secondary to atrophy, strokes, and other conditions |
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Acute impacts of hydrocephalus |
Impairment of gait, atypical eye movements, headaches, vomiting, and cognitive difficulties |
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Most common cause of hydrocephalus |
An obstruction that blocks the normal flow of CSF |
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Causes of ventricular dilation |
Inadequate absorption or production of CSF, loss of brain tissue because of atrophy, accumulation of CSF in the ventricles |
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Physical impacts of ventricular dilation |
Stretching and enlargement of periventricular white matter fibers, reductions in blood flow, neurochemical changes impacting glucose and oxygen utilization, accumulation of toxins |
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Hydrocephalus is considered this kind of syndrome |
Subcortical disconnection syndrome Because of injury to the long periventricular pathways (corpus callosum, projection pathways) that support communication across different brain regions |
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Congenital hydrocephalus |
Origin is typically very early in development |
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Acquired hydrocephalus |
May occur across the lifespan as a consequence of a disorder such as a tumor, infection, TBI, or dementia |
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Common types of congenital hydrocephalus |
Spina bifida myelomeningocele, aqueductal stenosis, Dandy-Walker syndrome, IVH |
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Internal hydrocephalus |
Obstructive hydrocephalus involving the foramen of Monro or aqueductal stenosis |
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External hydrocephalus |
Involves the subarachnoid spaces, most often used to describe individuals with disorders of CSF absorption (meningitis) and other forms of hydrocephalus external to the ventricles that do not necessarily involve increased ICp |
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Communicating hydrocephalus |
Abnormalities of CSF absorption Ex. Development of enlarged ventricles in people with dementia and other conditions that are associated with loss of brain tissue |
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Non-communicating hydrocephalus |
The obstructive form of hydrocephalus Ex. Congenital disorders, cysts |
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Normal pressure hydrocephalus |
Accumulation of CSF in the ventricles with ventriculomegaly ICP can be sporadic and fluctuating Sometimes no obvious cause, other times due to tumor, hemorrhage, TBI |
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Risk factors for idiopathic hydrocephalus |
Hypertension, vascular disease, and diabetes |
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Risk factors for spina bifida |
Vitamin B9 (folate) deficiency, family history of neural tube defects, some medications (ex. Valproic acid), diabetes, obesity, increased body temperature in the first few weeks of pregnancy |
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Complications of spina bifida |
Walking and mobility problems, orthopedic complications, bowel and bladder problems, hydrocephalus, shunt malfunction, chiari II malformation, meningitis, tethered spinal cord, sleep-disordered breathing, skin problems, latex allergy, UTIs, GI problems, depression, LDs, ADHD |
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Chiari II malformation |
Small posterior fossa, cerebellum is herniated and downwardly extends through the foramen of monro, cerebellum is abnormal, crowding effects on the medulla and tectum, corpus callosum abnormal because of failure of the rostrum or splenium to develop or thinning secondary to hydrocephalus Causes obstruction of the 4th ventricle |
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Structural brain differences in myelomeningocele |
Overall reductions in gray and white matter volumes, most apparent posteriorly Increased CSF Abnormalities of the caudate, palladium, and long projection fibers of the corpus callosum Gyrification reduced frontally and enhanced posteriorly Hippocampus is reduced in volume and integrity |
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Aqueductal stenosis |
Congenital narrowing of the aqueduct of Sylvius Some downward extension of the cerebellum may be present Partial callosal hypogenesis in about 20% of cases |
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Dandy Walker syndrome |
Cystic 4th ventricle Posterior fossa is enlarged with expansion of the 4th ventricle Partial to complete agenesis of the cerebellar vermis Corpus callosum abnormalities Malformations of the heart, face, limbs, fingers, and toes possible |
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Symptoms of Dandy Walker syndrome |
In infancy - slow motor development, progressive enlargement of the skull Increased head circumference, bulging at the back of the skull, abnormal breathing problems, and problems with the nerves that control the eyes, face, and neck |
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Normal pressure hydrocephalus is most common in this age group |
People over 65 |
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Determinants of severity of hydrocephalus in spina bifida |
Severity of chiari II malformation, presence of textual braking and hypogenesis of the corpus callosum, level of the spinal lesion |
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Determinants of severity in aqueductal stenosis |
Severity of hydrocephalus, required treatment for hydrocephalus, presence of abnormalities of the cerebellum and corpus callosum |
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Determinants of severity in Dandy Walker syndrome |
Severity of the cystic malformation and degree of vermis hypogenesis |
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Most common shunt placement |
In a right posterior ventricle with a valve that drains into the peritoneal cavity |
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Endoscopic third ventriculostomy |
The floor of the third ventricle is perforated to drain CSF |
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Treatment of problems with CSF absorption |
Medications that absorb excess fluid |
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CSF circulation |
Back (Definition) |
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In context of congenital hydrocephalus, expectations for neuropsyc assessment |
VCI > PRI Poor scores on tests with a timed motor component Word reading, spelling better than other academic skills, math most profoundly impaired Poor attention, major problems with orienting and disengaging attentional focus Extremely deficient processing speed Good language skills, but difficulties with language comprehension, prosodics, and pragmatics Complex configurational skills impaired Verbal and nonverbal learning and retrieval are usually impaired Impaired on most test of EF, reflect attention and motor problems Upper extremity motor deficits, simple tactile sensation intact, complex tactile impaired, procedural learning intact High interest in people, hyper social, overly talkative, intrusive Depression can develop |
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NPH often not identified and frequently mistaken for... |
Dementia or Parkinson’s disease |
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Adulthood considerations |
Level of independence is of concern Often unable to drive without modifications for physical disabilities Rates of unemployment and underemployment are high Response to stimulant meds less positive, commonly over medicated |
