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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
Q

What imaging is used to diagnose brain tumors?

A

MRI with contrast is the imaging modality of choice

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26
Q

What is the role of biopsy in brain tumor diagnosis?

A

To confirm the type and grade of the tumor for treatment planning

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27
Q

Surgical resection followed by radiation therapy and chemotherapy (temozolomide)

A

What is the treatment for glioblastoma multiforme?

28
Q

What is the most common source of brain metastases?

A

Lung cancer, followed by breast cancer and melanoma

29
Q

What are the potential complications of untreated brain tumors?

A

Increased intracranial pressure, brain herniation, death

30
Q

How are benign brain tumors like meningiomas typically managed?

A

Surgical resection, though some asymptomatic tumors can be observed with serial imaging

31
Q

What is a subarachnoid hemorrhage (SAH)?

A

Bleeding into the subarachnoid space, usually due to a ruptured aneurysm

32
Q

What is the hallmark symptom of subarachnoid hemorrhage?

A

Sudden onset of a “thunderclap” headache, described as the worst headache of the patient’s life

33
Q
A
34
Q

What are the common causes of subarachnoid hemorrhage?

A

Ruptured cerebral aneurysm and arteriovenous malformations (AVMs)

35
Q

What imaging is used to diagnose subarachnoid hemorrhage?

A

Non-contrast CT scan of the head

36
Q

What is the next diagnostic step if a CT scan is negative but suspicion for SAH remains high?

A

Lumbar puncture to check for xanthochromia (yellowish CSF)

37
Q

What is the initial treatment for subarachnoid hemorrhage?

A

Stabilization, blood pressure control, and neurosurgical consultation for aneurysm clipping or coiling

38
Q

What are the potential complications of subarachnoid hemorrhage?

A

Rebleeding, vasospasm, hydrocephalus, seizures

39
Q

What is the role of nimodipine in subarachnoid hemorrhage management?

A

To prevent cerebral vasospasm, a common cause of delayed ischemia after SAH

40
Q

What is the prognosis for patients with subarachnoid hemorrhage?

A

High mortality rate, but early treatment improves outcomes

41
Q

What are the risk factors for subarachnoid hemorrhage?

A

Hypertension, smoking, family history, polycystic kidney disease

42
Q

What are the major perioperative risks in neurosurgery?

A

How is the risk of seizures managed perioperatively in neurosurgery?

43
Q

What is the role of preoperative imaging in neurosurgery?

A

To assess the location, size, and extent of lesions or abnormalities

44
Q

What are the risk factors for poor wound healing in neurosurgery?

A

Diabetes, malnutrition, corticosteroid use

45
Q

How is the risk of postoperative infection reduced in neurosurgery?

A

Prophylactic antibiotics and strict sterile technique

46
Q

What is the most common complication following craniotomy?

A

Cerebral edema, managed with corticosteroids and close monitoring

47
Q

What is the role of postoperative imaging in neurosurgery?

A

To evaluate for complications such as hemorrhage or incomplete resection

48
Q

How is the risk of venous thromboembolism (VTE) managed in neurosurgery patients?

A

Prophylactic anticoagulation and early mobilization

49
Q

What are the signs of increased intracranial pressure post-neurosurgery?

A

Headache, nausea, vomiting, altered mental status, and bradycardia

50
Q

What is the typical follow-up care for neurosurgery patients?

A

Regular neurological exams, imaging, and management of long-term complications like seizures

51
Q

What is the purpose of a lumbar puncture (LP)?

A

To obtain cerebrospinal fluid (CSF) for diagnostic testing or to relieve intracranial pressure

52
Q

What are the common indications for lumbar puncture?

A

Suspected meningitis, subarachnoid hemorrhage, and demyelinating diseases

53
Q

What are the contraindications to lumbar puncture?

A

Increased intracranial pressure, infection at the puncture site, coagulopathy

54
Q

What position is the patient typically in for a lumbar puncture?

A

Lateral decubitus or sitting position with the spine flexed

55
Q

What are the potential complications of lumbar puncture?

A

Post-lumbar puncture headache, infection, bleeding, herniation

56
Q

What is the role of lumbar puncture in diagnosing subarachnoid hemorrhage?

A

To detect xanthochromia if the CT scan is negative but suspicion remains high

57
Q

How is cerebrospinal fluid (CSF) analyzed after lumbar puncture?

A

For cell count, glucose, protein, and the presence of bacteria or blood

58
Q

What is the normal opening pressure in lumbar puncture?

A

6-20 cm H₂O

59
Q

What is the typical CSF finding for bacterial meningitis?

A

Increased opening pressure, >1,000 WBC (neutrophil predominance), high protein, low glucose

60
Q

What are the CSF findings for viral (aseptic) meningitis?

A

Normal or slightly elevated opening pressure, 100-1,000 WBC (lymphocyte predominance), normal or mildly elevated protein, normal glucose

61
Q

What are the typical CSF findings in subarachnoid hemorrhage?

A

Xanthochromia (yellow CSF), increased opening pressure, normal or mildly increased WBC, elevated protein, normal glucose

62
Q

What is the classic CSF finding in Guillain-Barré syndrome?

A

Guillain-Barré Syndrome classically has elevated protein with normal WBC

Normal WBC (<10), markedly elevated protein (>400 mg/dL) (albuminocytologic dissociation), normal glucose.

63
Q

What CSF findings are associated with multiple sclerosis?

A

Mild pleocytosis (10-50 WBC, lymphocytic), normal or mildly elevated protein, normal glucose, presence of oligoclonal bands

64
Q

What is the treatment for post-lumbar puncture headache?

A

Bed rest, hydration, analgesics, and sometimes a blood patch

65
Q

What are the signs of a successful lumbar puncture?

A

Clear, colorless CSF flow and normal opening pressure

Surgery EOR (billie) (23 decks)

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