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Case Base Learning (CBL2) 2nd Year M.B.B.S MODULE – NEUROSCIENCE


Theme (Hydrocephalus)

A 35-year-old male working in a factory has progressive headache for 6 months. In the last one month, he also developed vomiting and memory impairment. Sometimes, he had incontinence of urine. He has also complaint of double vision. His pulse is 56/min, BP 150/90 mm Hg. No history of trauma, hypertension and diabetes mellitus. On fundoscopy, optic disc margins are blurred. He has imbalance on walking.

Investigation: Complete Blood Count (CBC), Urea Creatinine and Electrolyte (UCE) and Blood Sugar are normal.


  1. Anatomy:
  2. Define ventricular system.
  3. What are the different parts of ventricular system?
  4. What is the shape and anatomical location of each ventricle?


  1. Physiology:
  2. What is CSF and from where it is generated?
  3. Give normal ranges for following parameters of CSF:
  • Amount
  • Pressure
  • Rate of secretion
  1. Give route of CSF circulation.
  2. How is CSF absorbed and drained.


  1. Biochemistry:
  2. Differentiate between the normal and abnormal composition of CSF.


  1. Pathology:


  1. What are the causes of hydrocephalus?
  2. What is the pathogenesis of communicating and obstructive hydrocephalus?
  3. What is normal pressure hydrocephalus and what is idiopathic intracranial hypertension?


  1. Pharmacology:
  2. How to reduce the volume of CSF by following drugs?
    1. Acetazolomide
    2. Mannitol
    3. Corticosteroid
  3. Community Health Sciences:


  1. Name the most common causative microorganism causing the hydrocephalus.
  2. How to prevent the hydrocephalus caused by the most common microoraganism?


  1. Radiology:
  2. Search scans of post fossa (cerebellar) masses causing hydrocephalus (obstructing) including primary masses and secondary deposits.

Note:         Non – neoplastic space occupying lesions like Tuberculoma, Sarcoidosis,    Fungal Infection, Parasitic lesions and Abscess.


Book References:

  • Neuro-Anatomy by Snell
  • Neurology Neurosurgery illustrated
  • Robin’s Basic Pathology
  • Guyton Textbook (Major)
  • Ganong Review of Physiology
  • Sherwood text book of Physiology
  • Pathologic Basis of Disease
  • Lippincott (Bio-Chemistry)

Web Based Article:

  • Khan Academy
  • YouTube