Neurosurgery Ward Rounds/Tutorials

Question 1

What do you have to rule out in a patient with unilateral hearing loss?

Answer 1

Acoustic neuroma

Question 2

What are some presenting signs or symptoms of acoustic neuroma?

Answer 2

Hearing loss

Tinnitus

Vertigo

Headache

Facial weakness/numbness

Question 3

What are acoustic neuromas?

Answer 3

Intracranial, extra-axial tumours arising from the Schwann cell sheath that invests the vestibular or cochlear nerve

Question 4

In which condition must you look out for bilateral acoustic neuromas?

Answer 4

Neurofibromyetosis type II

Question 5

What is a chiari malformation? What do you look out for in a patient with one?

Answer 5

A congenital abnormality causing a small posterior fossa

Syrinx (CSF in the spinal cord)

Hydrocephalus

Question 6

What is a rathke cleft cyst?

Answer 6

A benign

Question 7

What are Iddo’s 5 E’s of CT reporting?

Answer 7

Exam

Exact location (intra vs extra-axial)

Enhancement

Effect

Evaluation

Question 8

What is Gertmann’s syndrome characterised by? Where is the lesion?

Answer 8

Agraphia

Finger Agnostia

Left-Right disorientation

Acalculia

Angular gyrus