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Flashcards in Neurosurgery Deck (18)
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0
Q

Most common cause of TIA (2)

A

High grade stenosis of internal carotid

Ulcerated plaque at carotid bifurcation

1
Q

Sudden loss of neurologic function
No headache
Resolve spontaneously leaving no sequela

A

Transient ischemic attack

2
Q

Workup after TIA

Tx if lesions found

A

Duplex study
Carotid endarterectomy
Filter, angioplasty, stenting

3
Q

Sudden onset of neurologic deficits
No headache
Deficits present for > 24 h
Dx, tx?

A

Ischemic stroke
CT scan
Rehabilitation, tPA for very early strokes (within 90 minutes) after hemorrhage ruled out, vascular workup to predict future stroke risk

4
Q

Uncontrolled hypertensive
Sudden severe headache, then neurologic deficits
Dx Tx?

A

Hemorrhagic stroke
CT scan
Control hypertension, rehabilitation

5
Q

Sudden severe headache
Sometimes no neurological deficits
May return with same symptoms and deficits a week later
May show meningeal irritation or nuchal rigidity
Dx Tx?

A

Subarachnoid bleed from intracranial aneurysm
CT scan, spinal tap, arteriogram
Clipping of aneurysm or endovascular coiling

6
Q

Progressively increasing headache over months
Worse in morning
Signs of increased ICP
Dx, tx?

A

Brain tumor
MRI preferred
Surgical removal, treat ICP with dexamethasone

7
Q

What is Cushing’s reflex

A

Bradycardia with hypertension

8
Q

Inappropriate behavior
Optic nerve atrophy
Papilledema
Anosmia

A

Base of frontal lobe tumor

9
Q

Young, short for age
Bitemporal hemianopsia
Calcified lesion above sella turcica

A

Craniopharyngioma

10
Q

Amenorrhea, galactorrhea

Dx tx?

A

Prolactinoma
MRI of sella turcica, r/o pregnancy, hypothyroid, get prolactin level

Bromocriptine or transnasal,trans-sphenoidal surgical removal

11
Q

HTN, DM, sweaty hands, headache
Hats, wedding bands no longer fit
Dx tx?

A

Acromegaly
Pituitary MRI, determine somatomedin C
Surgical removal or radiation

12
Q

H/x pituitary tumor
Severe headache
Deterioration of vision, pallor of optic nerves
Dx tx?

A

Pituitary apoplexy
MRI or CT
Steroid, hormone replacement

13
Q

Loss of upper gaze

Parinaud syndrome

A

Pineal gland tumor

14
Q

Child in knee-chest position

Cerebellar symptoms- ataxia, stumbling

A

Posterior fossa tumor

15
Q

1-2 weeks tumor symptoms
Fever
Commonly recent otitis media or mastoiditis
Dx tx?

A

Brain abscess
CT
Surgical resection

16
Q

Sharp shooting pain in face
Usually with trigger zone
Older patients
Dx tx?

A

Trigeminal neuralgia
MRI to r/o lesion
Anticonvulsants or radiofrequency ablation

17
Q

H/x crushing injury 3 months ago
Constant burning pain made worse by touching
Cold cyanotic and moist
Dx tx?

A

Reflex sympathetic dystrophy
Successful sympathetic block diagnostic
Surgical sympathectomy