Neurosurgery Flashcards
Visual defect with lesion at the retina
Central scotoma
Visual defect of the right optic nerve
(Right) monocular vision loss
Visual defect of the optic chiasm
Bitemporal hemianopia
Visual defect of the right optic tract
Contralateral (left) homonymous hemianopia
Visual defect at brainstem with PCA occulusion
Contralateral homonymous heminanopia
Management of ventriculitis
IV Ceftazidime
IV Vancomycin
Classification of brain tumours
Supratentorial
Infratentorial
Relates to whether tumour is above or below the tentorium cerebelli
Parietal lobe tumours
Gerstmann Syndrome
May see dyspraxia Agraphia Acalculia Finger agnosia Left-right disorientation
Contrast and MRI
Only give contrast in T1 MRI scans
Ventricles appear dark
Chemotherapy used 1st line in GBM
Temozolamide
2nd line chemotherapy in GBM
PCV - procarbazine, CCNU, vincristine
Important investigation in acoustic neuromas
Audiometry/audiology
If hearing is good and tumour small, may not intervene surgically as risk damage and hearing loss
Investigations used in germ cell tumours
Alpha fetoprotein
B-HCG
LDH
Modern management of hydrocephalus
ETV - endoscopic third ventriculostomy
Traditional management of hydrocephalus
VP shunts
TACI
Higher cerebral dysfunction
Homonymous visual field defect
Ipsilateral motor and/or sensory deficit to at least 2 areas (face, arms, legs)
PACI
Only 2 of the 3 components of TACI
Presentation of posterior circulation infarct (4)
Any of the following: Bilateral motor/sensory deficit Isolated homonymous visual field defect Ipsilateral cranial nerve palsy with contralateral motor and/or sensory deficit Disorder of conjugate eye movement
Presentation of a Lacunar Infarct (5)
One of 4 main clinical lacunar syndromes Pure motor/hemiparesis Ataxis hemiparesis Dysartria/clumsy hand Pure sensory stroke Mixed sensorimotor stroke
Thrombolysis protocol for stroke
Need to be initiated within 3 hours of symptom onset
Must be within 4.5 hours at most
Dose is 0.9mg/kg up to 90mg: 10% as bolus, rest as infusion
Glabellar reflex =
Primitive blink reflex
Tapped on forehead, should stop blinking within 5 times
Associated with frontal lobe pathology
Presentation of cervical myelopathy (6)
Hoffmans Sign +VE Pain in neck, shoulders and arms Weakness in arms Unable to pick up objects Wide based gait Positive Babinski/UMN signs
Hoffman’s Sign =
Involuntary flexion movement of the thumb and index finger on tapping middle finger nail
Management of Subarachnoid Haemorrhage
CT angiogram
Endovascular Coiling
Risks with ACDF (4)
Hoarseness
Horner’s Syndrome
Swallowing Difficulties
Failure to Fuse
