Hydrocephalus

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The main site of CSF absorption are arachnoid granulations of

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A. Superior sagittal

B. Inferior sagittal

C. Transverse

D. Cavernous

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All are true of Idiopathic Intracranial Hypertension except

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A. Typically seen in young, overweight women

B. Can progress rapidly to blindness

C. Ventricular enlargement in CT is an initial finding

D. Otherwise called pseudotumour cerebri

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Not true of the classic Hakim triad

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A. Classic gait impairment consists of a wide-based gait
B. Dementia
C. Papilloedema
D. Urinary incontinence

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All are true of Parinaud syndrome except

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A. Downward gaze palsy
B. Convergence retraction nystagmus
C. Light-near dissociation
D. Bilateral lid retraction

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Mickey Mouse” sign in computed tomographic (CT) is due to

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A. Periventricular hypoattenuation
B. Damage to pretectal nucleus
C. Aqueductal obstruction
D. CSF extravasation

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Most common shunt used to treat hydrocephalus is

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A. External ventricular drain
B. Ventriculo-pleural shunt
C. Ventriculoatrial shunt (VA) shunt
D. Ventriculoperitoneal (VP) shunt

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In short

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Lumboperitoneal shunt

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• A lumboperitoneal shunt is considered in cases of pseudotumor cerebri.

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Endoscopic third ventriculostomy

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• Endoscopic third ventriculostomy (ETV) is commonly used in cases of aqueductal stenosis to prevent a permanent shunt.

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Choroid plexus coagulation

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• Choroid plexus coagulation can be used for cases of over-production of CSF. Repeat lumbar punctures can be done in cases of communicating hydrocephalus if it’s considered that spontaneous resorption is likely to occur.

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External ventricular drain

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• Acute hydrocephalus is a medical emergency, placement of external ventricular drain is the most common procedure performed in these cases.

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Serial fontanelle taps

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• Premature infants with posthemorrhagic hydrocephalus may improve with serial fontanelle taps.

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