Cranial Neurosurgery Flashcards
(48 cards)
When high pressure headache of raised ICP is worsen ?
On coughing or bending forward
What is detected in fundoscopy in Raised ICP
Papilloedema
Loss of upgaze known as sunsetting is a feature of which syndrome ?
Parinaud’s Syndrome
What is the first line investigation to identify cause of raised ICP ?
CT
What is the gold standard for quantifying ICP and monitoring in real time ?
EVF or insertion of a pressure monitor
Clinical features of acutely raised ICP ?
1)High Pressure Headache 2)Nausea And vomiting 3)Diplopia And Blurred Vision 4)Drowsiness then coma
Where is CSF absorbed?
Arachnoid Granulations
Who are presented with idiopathic intracranial hypertension? (IIH)
Young overweight women
Clinical features of IIH
High pressure headaches and visual deterioration
Findings of IIH
1)Papilloedema 2)Occasionally Cranial nerve palsies 3) Imaging is unremarkable 3) Lumbar punture demonstrates a raised opening pressure >25mmHg
Management of IIH
1)Weight loss 2)Cessation of OCP
3)Acetazolamide to reduce CSF production
4)Serial lumbar puncture and CSF diversion as a last resort
Normal pressure hydrocephalus features
🫐Potentially reversible cause of dementia
🫐Gait Disturbance
🫐Incontinence
🫐Cognitive Decline
Where is EVF inserted ?
At Kocher’s point ( Right of midline, Anterior to the coronal suture)
Typical organisms of meningitis are
Staphylococcus aureus , Enterobacteriaceae , Pseudomonas , pneumococci
Clinical features of meningitis
1)Fever 2)Headache 3)Neck Stiffness 4)Photophobia
Clinical features of brain abscess
🍓Low Grade Fever
🍓Confusion
🍓Seizures and focal deficit
What is the initial imaging modality of choice in brain abscess ?
CT scan with contrast
Findings of CT scan with contrast for brain abscess
🫐In first few days hypo dense oedematous brain representing early cerebritis is visible
🫐 As the abscess matures classic appearances of a smooth walled , well defined , ring enhancing mass develop
A subdural empyema associated with osteomyelitis of the frontal Bone and associated scalp swelling is known as
Pott’s puffy tumour
What is the CT appearances of subdural empyema?
🍓Appearances of hypo dense or isodense sub Dural collection, with contrast enhancement at the margins and often swelling and midline shift
🍓Typically a crescentic collection with a contrast enhancing rim
What is the mainstay treatment of sub Dural empyema ?
Drainage
How TB infection of CNS represents from primary pulmonary foci?
Haematogenous spread
Primary sites of TB
Lungs, lymph node , Gut , Skin
Most common cause of SAH
Trauma
