Neurosurgery Cards

Question 1

What is a syndrome?

Answer 1

A group of Symptoms and signs due to an underlying cause.

Question 2

What is a stroke?

Answer 2

An acute onset of a neurological clinical syndrome as a manifestation of an underlying cerebrovascular event.

Question 3

What is the first line investigation for ?stroke ?

Answer 3

CT head

Question 4

What three neurosurgically relevant categories can stroke be classified into?

Answer 4

SAH
Ischaemic
Spontaneous brain parenchymal haemorrhage.

Question 5

What % of CT Heads are -ve for SAH, when they do have a SAH?

Answer 5

10%

Question 6

What follow up investigations should be done where a ?SAH has a negative result?

Answer 6

LP.
To check for xanthochromia in supernatant
To check for increased bilirubin on CSF spectrophotometry.

Question 7

What are the causes of a SAH?

Answer 7

Berry aneurysm rupture (80-90%)
Rare causes
Cause undetermined (angiogram -ve for ~10%, minimal risk of serious complications)

Question 8

What are risk factors for aneurysm formation?

Answer 8

FHx
HTN
Smoking

Question 9

Where do berry aneurysms normally form?

Answer 9

At junctions points around the circle of willis or at the main MCA bifurcation.

Question 10

What are three rare causes for a SAH?

Answer 10

AVMs
Arterial dissection
Tumour.

Question 11

What are the outcomes of a Berry aneurysm SAH?

Answer 11

1/3 of pts die immediately
1/3 of pts die within 48hrs
1/3 of pts survive,
-10% of which suffer a stroke from SAH-associated arterial vasospasm.

Question 12

What does the overall management of a SAH consist of?

Answer 12

Dealing with the complications of aneurysmal SAH.

Securing the causative Berry aneurysm at an appropriate time point.

Question 13

Give 5 compilations of a SAH.

Answer 13

Hydrocephalous requiring the insertion of an external ventricular drain