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Surgery EOR (billie) > Neurosurgery > Flashcards

Neurosurgery Flashcards

1
Q

What is carpal tunnel syndrome?

A

Compression of the median nerve as it passes through the carpal tunnel in the wrist

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2
Q

What are the common symptoms of carpal tunnel syndrome?

A

Numbness, tingling, and pain in the thumb, index, and middle fingers, especially at night

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3
Q

What physical exam tests are used to diagnose carpal tunnel syndrome?

A

Tinel’s sign (tapping the wrist) and Phalen’s test (flexing the wrist)

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4
Q

What is the first-line treatment for mild carpal tunnel syndrome?

A

What is the first-line treatment for mild carpal tunnel syndrome?

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5
Q

What is the role of corticosteroid injections in carpal tunnel syndrome?

A

Temporary relief of symptoms in moderate cases or those unresponsive to conservative treatment

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6
Q

What is the definitive treatment for severe or refractory carpal tunnel syndrome?

A

Carpal tunnel release surgery to decompress the median nerve

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7
Q

What are the risk factors for developing carpal tunnel syndrome?

A

Repetitive hand use, pregnancy, diabetes, hypothyroidism

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8
Q

How is carpal tunnel syndrome diagnosed definitively?

A

Electromyography (EMG) and nerve conduction studies

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9
Q

What is the typical prognosis after carpal tunnel release surgery?

A

Most patients experience significant symptom relief and functional improvement

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10
Q

What are the complications of untreated carpal tunnel syndrome?

A

Permanent nerve damage, muscle atrophy, and loss of hand function

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11
Q

What is an epidural hematoma?

A

A collection of blood between the dura mater and the skull, usually due to trauma

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12
Q

What artery is most commonly involved in an epidural hematoma?

A

Middle meningeal artery

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13
Q

What is the typical presentation of an epidural hematoma?

A

Brief loss of consciousness followed by a lucid interval and then rapid neurological deterioration

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14
Q

What imaging is used to diagnose an epidural hematoma?

A

CT scan of the head showing a biconvex, hyperdense lesion

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15
Q

What is the initial treatment for an epidural hematoma?

A

Emergent neurosurgical evacuation (craniotomy) to relieve pressure

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16
Q

What are the potential complications of untreated epidural hematoma?

A

Brain herniation, coma, death

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17
Q

What is the hallmark finding of an epidural hematoma on a CT scan?

A

A lens-shaped (biconvex) collection of blood that does not cross suture lines

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18
Q

How does an epidural hematoma differ from a subdural hematoma?

A

Epidural hematomas are arterial bleeds and present with a lucid interval, while subdural hematomas are venous and have a slower onset

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19
Q

What is the prognosis of an epidural hematoma with timely treatment?

A

Good if treated promptly, with full recovery in many cases

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20
Q

What are the risk factors for developing an epidural hematoma?

A

Head trauma, particularly in younger individuals due to increased arterial vulnerability

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21
Q

What are the two main categories of brain tumors?

A

Primary brain tumors and metastatic brain tumors

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22
Q

What is the most common primary brain tumor in adults?

A

Glioblastoma multiforme

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23
Q

What is the most common benign brain tumor?

A

Meningioma

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24
Q

What are the common symptoms of brain tumors?

A

Headache, seizures, focal neurological deficits, cognitive changes

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25
What imaging is used to diagnose brain tumors?
MRI with contrast is the imaging modality of choice
26
What is the role of biopsy in brain tumor diagnosis?
To confirm the type and grade of the tumor for treatment planning
27
Surgical resection followed by radiation therapy and chemotherapy (temozolomide)
What is the treatment for glioblastoma multiforme?
28
What is the most common source of brain metastases?
Lung cancer, followed by breast cancer and melanoma
29
What are the potential complications of untreated brain tumors?
Increased intracranial pressure, brain herniation, death
30
How are benign brain tumors like meningiomas typically managed?
Surgical resection, though some asymptomatic tumors can be observed with serial imaging
31
What is a subarachnoid hemorrhage (SAH)?
Bleeding into the subarachnoid space, usually due to a ruptured aneurysm
32
What is the hallmark symptom of subarachnoid hemorrhage?
Sudden onset of a "thunderclap" headache, described as the worst headache of the patient’s life
33
34
What are the common causes of subarachnoid hemorrhage?
Ruptured cerebral aneurysm and arteriovenous malformations (AVMs)
35
What imaging is used to diagnose subarachnoid hemorrhage?
Non-contrast CT scan of the head
36
What is the next diagnostic step if a CT scan is negative but suspicion for SAH remains high?
Lumbar puncture to check for xanthochromia (yellowish CSF)
37
What is the initial treatment for subarachnoid hemorrhage?
Stabilization, blood pressure control, and neurosurgical consultation for aneurysm clipping or coiling
38
What are the potential complications of subarachnoid hemorrhage?
Rebleeding, vasospasm, hydrocephalus, seizures
39
What is the role of nimodipine in subarachnoid hemorrhage management?
To prevent cerebral vasospasm, a common cause of delayed ischemia after SAH
40
What is the prognosis for patients with subarachnoid hemorrhage?
High mortality rate, but early treatment improves outcomes
41
What are the risk factors for subarachnoid hemorrhage?
Hypertension, smoking, family history, polycystic kidney disease
42
What are the major perioperative risks in neurosurgery?
How is the risk of seizures managed perioperatively in neurosurgery?
43
What is the role of preoperative imaging in neurosurgery?
To assess the location, size, and extent of lesions or abnormalities
44
What are the risk factors for poor wound healing in neurosurgery?
Diabetes, malnutrition, corticosteroid use
45
How is the risk of postoperative infection reduced in neurosurgery?
Prophylactic antibiotics and strict sterile technique
46
What is the most common complication following craniotomy?
Cerebral edema, managed with corticosteroids and close monitoring
47
What is the role of postoperative imaging in neurosurgery?
To evaluate for complications such as hemorrhage or incomplete resection
48
How is the risk of venous thromboembolism (VTE) managed in neurosurgery patients?
Prophylactic anticoagulation and early mobilization
49
What are the signs of increased intracranial pressure post-neurosurgery?
Headache, nausea, vomiting, altered mental status, and bradycardia
50
What is the typical follow-up care for neurosurgery patients?
Regular neurological exams, imaging, and management of long-term complications like seizures
51
What is the purpose of a lumbar puncture (LP)?
To obtain cerebrospinal fluid (CSF) for diagnostic testing or to relieve intracranial pressure
52
What are the common indications for lumbar puncture?
Suspected meningitis, subarachnoid hemorrhage, and demyelinating diseases
53
What are the contraindications to lumbar puncture?
Increased intracranial pressure, infection at the puncture site, coagulopathy
54
What position is the patient typically in for a lumbar puncture?
Lateral decubitus or sitting position with the spine flexed
55
What are the potential complications of lumbar puncture?
Post-lumbar puncture headache, infection, bleeding, herniation
56
What is the role of lumbar puncture in diagnosing subarachnoid hemorrhage?
To detect xanthochromia if the CT scan is negative but suspicion remains high
57
How is cerebrospinal fluid (CSF) analyzed after lumbar puncture?
For cell count, glucose, protein, and the presence of bacteria or blood
58
What is the normal opening pressure in lumbar puncture?
6-20 cm H₂O
59
What is the typical CSF finding for bacterial meningitis?
Increased opening pressure, >1,000 WBC (neutrophil predominance), high protein, low glucose
60
What are the CSF findings for viral (aseptic) meningitis?
Normal or slightly elevated opening pressure, 100-1,000 WBC (lymphocyte predominance), normal or mildly elevated protein, normal glucose
61
What are the typical CSF findings in subarachnoid hemorrhage?
Xanthochromia (yellow CSF), increased opening pressure, normal or mildly increased WBC, elevated protein, normal glucose
62
What is the classic CSF finding in Guillain-Barré syndrome?
Guillain-Barré Syndrome classically has elevated protein with normal WBC Normal WBC (<10), markedly elevated protein (>400 mg/dL) (albuminocytologic dissociation), normal glucose.
63
What CSF findings are associated with multiple sclerosis?
Mild pleocytosis (10-50 WBC, lymphocytic), normal or mildly elevated protein, normal glucose, presence of oligoclonal bands
64
What is the treatment for post-lumbar puncture headache?
Bed rest, hydration, analgesics, and sometimes a blood patch
65
What are the signs of a successful lumbar puncture?
Clear, colorless CSF flow and normal opening pressure
66
what is the MC artery involved in a stroke
middle cerebral artery

Surgery EOR (billie) (24 decks)

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