PreTest Surgery: Neurosurgery

Question 1

Review the GCS categories and points.

Answer 1

Eyes open:

• 1: never
• 2: to pain
• 3: to vocal commands
• 4: spontaneously

Best verbal response:

• 1: none
• 2: incomprehensible
• 3: inappropriate words
• 4: inappropriate content
• 5: oriented and appropriate

Limbs move:

• 1: never
• 2: abnormal extension
• 3: abnormal flexion
• 4: withdraws to pain
• 5: purposeful movements
• 6: obeys commands

Question 2

What is a big caveat in using hyperventilation to treat ICH?

Answer 2

It is only good as a temporary measure –not for prolonged treatment.

Question 3

Describe the management of basilar skull fractures.

Answer 3

Observation

If the rhinorrhea of CSF is persistent (greater than 14 days), then surgery is indicated to repair torn dura.

Question 4

Tumors of the pituitary often take on a ___________ shape.

Answer 4

dumbbell (due to the diaphragm of the sella)

Question 5

Workup for subarachnoid hemorrhage should include _______________.

Answer 5

4-vessel cerebral angiogram

Question 6

Papilledema usually results from ____________ intracranial hypertension.

Answer 6

chronic

Question 7

Craniopharyngiomas are treated with ______________.

Answer 7

surgical resection (or radiotherapy if surgery is not possible)

Question 8

True or false: those with substantial brain contusions should be managed with observation if they are asymptomatic. q

Answer 8

False

One week of anticonvulsants should be given to prophylactically treat seizures.

Question 9

How do brain abscesses present?

Answer 9

• FND
• Seizures
• Often without fever, tachycardia, or elevated WBC

Question 10

To evaluate for brain abscess, get what kind of image?

Answer 10

Contrast-enhanced CT

Question 11

An FND days after a head trauma (with no intervening symptoms) is likely a ____________.

Answer 11

subdural hematoma