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Surgery > Pestana- 11. Neurosurgery > Flashcards

Pestana- 11. Neurosurgery Flashcards

1
Q

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

A

hemorrhagic will have severe headache

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2
Q

What is the most common origin of a TIA?

A

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

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3
Q

How do you work up a patient with a TIA?

A

Duplex studies

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4
Q

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

A

3 hours

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5
Q

What is the management for hemorrhagic stroke?

A

control HTN

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6
Q

What kind of brain bleed comes from a ruptured aneurysm?

A

subarachnoid

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7
Q

How do patinets with ruptured aneurysms present?

A

thunderclap headache (worst of their life)

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8
Q

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

A

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

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9
Q

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

A

arteriogram

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10
Q

What is the treatment for intracranial aneurysm?

A

clipping or coiling

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11
Q

True or false: most brain cancers are mets.

A

True!

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12
Q

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

A

lung (then breast and melanoma)

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13
Q

What are the components of Cushing reflex?

A

bradycardia and hypertension

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14
Q

What leads to the Cushing reflex?

A

increased ICP

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15
Q

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

A

craniopharyngioma

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16
Q

What do you see on CT with a craniopharyngioma?

A

calcified lesion above sella turcica

17
Q

How do you work up a prolactinoma?

A

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

18
Q

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

A

pituitary apoplexy

19
Q

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

A

need to replace steroids

20
Q

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

A

pineal gland

21
Q

Where are brain tumors typically located in children?

A

posterior fossa

22
Q

What is the most common brain tumor in kids?

A

medulloblastoma (in cerebellum)

23
Q

What is the diagnostic imaging for brain abscess?

A

CT

24
Q

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

A

trigeminal neuralgia

25
Q

What is the typical medical treatment for trigeminal neuralgia?

A

carbamazapine

26
Q

What is causalgia?

A

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

27
Q

How do you diagnose reflex sympathetic dystrophy?

A

decrease of pain with sympathetic block

Surgery (13 decks)

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