Pestana- 11. Neurosurgery Flashcards Preview

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Flashcards in Pestana- 11. Neurosurgery Deck (27)
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1

How do you tell the difference between occlusive and hemorrhagic vascular brain problems?

hemorrhagic will have severe headache

2

What is the most common origin of a TIA?

High-grade stenosis (>70%) of ICA or ulcerated plaque at the carotid bifurcation

3

How do you work up a patient with a TIA?

Duplex studies

4

How long can you go before your ischemic stroke is no longer amenable to revascularization?

3 hours

5

What is the management for hemorrhagic stroke?

control HTN

6

What kind of brain bleed comes from a ruptured aneurysm?

subarachnoid

7

How do patinets with ruptured aneurysms present?

thunderclap headache (worst of their life)

8

Is the first aneurysmal bleed usually a patient's last (fatal)?

no- often patients will have sentinel bleed then ten days later have a terrible one

9

After CT, what test is done to evaluate an intracranial aneurysm?

arteriogram

10

What is the treatment for intracranial aneurysm?

clipping or coiling

11

True or false: most brain cancers are mets.

True!

12

What is the most common tumor that goes to the brain?

lung (then breast and melanoma)

13

What are the components of Cushing reflex?

bradycardia and hypertension

14

What leads to the Cushing reflex?

increased ICP

15

What tumor is suspected in children short for their age with bitemporal hemianopsia?

craniopharyngioma

16

What do you see on CT with a craniopharyngioma?

calcified lesion above sella turcica

17

How do you work up a prolactinoma?

r/o pregnancy
TSH level (h/o hypothyroidism)
Prolactin level
MRI of sella

18

What is it called when there is a bleed into the pituitary gland that kills the gland?

pituitary apoplexy

19

What should be given first to a patient with pituitary apoplexy?

need to replace steroids

20

Where is a tumor in a patient who has loss of upper gaze (sunset eyes)?

pineal gland

21

Where are brain tumors typically located in children?

posterior fossa

22

What is the most common brain tumor in kids?

medulloblastoma (in cerebellum)

23

What is the diagnostic imaging for brain abscess?

CT

24

What do you expect in a patient with a 60 second long sharp shooting pain in the face after grazing their cheek?

trigeminal neuralgia

25

What is the typical medical treatment for trigeminal neuralgia?

carbamazapine

26

What is causalgia?

reflex sympathetic dystrophy (constant, burning pain after crushing injury that does not respond to analgesics)

27

How do you diagnose reflex sympathetic dystrophy?

decrease of pain with sympathetic block