Neurosurgery Flashcards
(12 cards)
EMG and NCV are useful for assessing the funcion of
Peripheral nerves
- EMG records muscle activity in response to a proximal stimulation of the motor nerve
- NCS record the velocity and amplitude of the nerve action potential
- typically performed ~3 to 4 weeks after an acute injury
- nerves distal to the injury continue to transmit electrical impulses
The lesion that can cause mass effect and rapidly kill the patient is _________
Posterior fossa lesion
Occlusion of the 4th ventricle can lead to acute obstructive hydrocephalus, raised ICP, herniation and eventual death
brain stem compression
According to the GCS, a aptient with a head injury score of 5 is classified as
Severe
- Severe = 3 to 8
- Moderate = 9 to 12
- Mild = 13 to 15
In regard to halo test, a positive indicator for CSF when tinged with blood will show the following when dropped on an absorbent tissue
A double ring with a darker center spot, containing blood components surrounded by a light halo of CSF
- If indeterminate, the fluid can be sent for beta-2- transferrin testing, a carbohydrate free isoform
Neurapraxia is defined as
The temporaty failure of nerve function without physical axonal disruption
A patient who withdraws from pain, mumbling inappropriate words and opens his eyes to pain has a GCS score of
6
The most common malignant tumor of the brain is
Astrocytoma
- Grade I and II = low grade
- Grade III = anaplastic astrocytoma
- Grade IV = glioblastoma multiforme
- Median survival is 8 years after diagnosis with a low grade tumor
- 1 year survival for GBM
A 25 year old man is seen in the emergency department after he struck his head against the windshield in an automobile accident. He opens his eyes and withdraws his arm durig painful stimulation of his hand. He responds verbally to questions with inappropriate words. His GCS score is
9
The msot common level of cervical radiculopathy from cervical disc is
c6-c7
- Treatment
- Anterior cervical dissectomy and fusion
- more direct access
- Posterior cervical foraminotomy (keyhole formation)
- Anterior cervical dissectomy and fusion
A 35 year old mother of two children, has had amenorrhea and galactorrhea for the past 12 months. Her serum prolactin level is elevated and radiographs of her skull shown “Empty sella” The most likely diagnosis is ________
Pituitary adenomas
- <1cm = microadenoma
- functional vs nonfunctional
- The most common endocrine syndromes
- cushing, forbes albright, acromegaly
- Hemorrhage into the pituitary tumor = abrupt symptoms of headaches, visual disturbances, decreased mental status and endocrine dysfunction
The most common intradural extramedullary tumors in children
Astrocytomas
- interfere with CSF-containing central canal of the spinal cord
- dialted central canal = syrinx
- usually low grade
- complete excision is rarely possible due to the nonencapsulated
- worse than ependymoma
Diabetics, IV drug abusers, and dialysis patients have an increased risk of contracting the CNS infection
Pyogenic vertebral osteomyelitis
- Staphylococcus and Enterbacter
- Hematogenous or extension of adjacent disease
