Thomas Carroll Teaching

Question 1

List three examples of neurosurgical clinical syndromes.

Answer 1

Proximal myopathy (e.g., due to corticosteroid use).
Myelopathy (e.g., disc-osteophyte cord compression).
Cranial neuropathy.

Question 2

What are the red flag symptoms of raised intracranial pressure (ICP)?

Answer 2

Gradual onset progressive headache.
Nausea/vomiting.
Papilledema.
Drowsiness or cognitive decline.

Question 3

True/False: Symptoms appear after signs in conditions like peripheral neuropathy and myelopathy.

Answer 3

False (signs may appear before symptoms in these conditions).

Question 4

What are the key components of the “core neurologic examination”?

Answer 4

General appearance.
Vital signs.
Gait.
Fundoscopy.
Long tract signs.
Vibration sense.

Question 5

The _________ sign and _________ reflex are key components of long tract sign assessment.

Answer 5

Babinski; Hoffman’s.

Question 6

What imaging modality is preferred for acute head presentations and suspected blood?

Answer 6

CT scan.

Question 6

True/False: The best site to apply a pain stimulus for GCS assessment is between the mastoid process and the mandible.

Answer 6

True.

Question 7

Hounsfield units (Hu) are used in CT imaging, where _________ measures +1000 Hu, _________ measures 0 Hu, and _________ measures -1000 Hu.

Answer 7

bone; water; air.

Question 8

True/False: MRI is required for better visualization of posterior fossa and suspected demyelination.

Answer 8

True.

Question 9

What are the “golden rules” before transferring a head-injured patient for imaging?

Answer 9

Ensure the patient is stable (airway, breathing, circulation).
Suture scalp lacerations.
Monitor vital signs closely.

Question 10

A depressed level of consciousness should not be attributed to _________ until significant brain injury is excluded.

Answer 10

intoxication.

Question 11

True/False: Skull X-rays have no role in modern head injury assessment.

Answer 11

true

Question 12

What are the typical features of myelopathy?

Answer 12

Loss of fine finger movements (e.g., clumsiness, difficulty with buttons).
Gait instability (“legs feel heavy”).
Long tract signs (e.g., Babinski, spastic gait).

Question 13

The most common cause of myelopathy is _________ cord compression due to disc-osteophyte complexes.

Answer 13

cervical.

Question 14

True/False: Chronic subdural hematoma is common in the elderly and is managed via burr hole drainage.

Answer 14

True.

Question 15

What symptoms suggest meningeal irritation?

Answer 15

Severe headache.
Photophobia.
Neck stiffness.
Vomiting.

Question 16

Subarachnoid hemorrhage presents with a _________ headache and is confirmed with a _________ scan followed by a lumbar puncture.

Answer 16

thunderclap; CT.

Question 17

True/False: Most patients with intracranial tumors do not present with headaches.

Answer 17

True.

Question 18

How is acute rising ICP managed temporarily?

Answer 18

With mannitol (e.g., 20% solution) to reduce swelling.

Question 19

For perioperative hydrocortisone cover, start with _________ IV and taper as per endocrinologist guidance.

Answer 19

100mg QDS.

Question 20

True/False: Patients on dexamethasone should have daily glucose monitoring to check for hyperglycemia.

Answer 20

true