Neurosurgery

> Schwarts Chapter 42. Neurosurgery

Neuroanatomy

Neuroanatomy – Medical Archive

Neurologic examination

Diagnostic Studies

Emergencies

Raised Intracranial Pressure (IICP)

Etiology

Growth hormone
Tetracyclines
Excess vitamin A (eg, isotretinoin)

Clinical features

  • Throbbing headache
    • Worse with lying flat, improves with standing
    • May be accompanied by pulsatile tinnitus (ie, “whooshing” sound), N/V, and/or blurry vision.
  • Vision changes, papilledema
  • Cranial nerve palsy – abducens nerve (CN VI) palsy is m/c

Brain Stem Compression

Stroke

Siezure

Trauma

Head trauma

Spine trauma

The mechanics of spine trauma

Patterns of injury

Initial assessment and management

Neurologic syndromes

Studies

Definitive managment

  • Spinal-dose IV steroids
    • Anti-inflammatory and decrease the pressure on the spinal column.
    • The beneficial effect has been shown to be most significant within the first 8 hours of injury.
  • Orthotic devices
  • Surgery
  • Continued care.

Peripheral nerve trauma

Cerebrovascular Disease

Ischemic diseases

Thrombotic disease

Embolic disease

Hemorrhagic diseases

Tumors of the Central Nervous System

Intracranial tumors

Metastatic tumors

Glial tumors

Neural tumors and mixed tumors

Neural crest tumors

Miscellaneous tumors

Embryologic tumors

Spinal tumors

Intradural extramedullary tumors

Spine

Stability

Neural compression

Patterns of disease

Cervical radiculopathy

Cervical spondylotic myelopathy

Thoracic disc herniation

Lumbar radiculopathy

Neurogenic claudication

Conus medullaris syndrome & Cauda equina syndrome

Spine fusion surgery

Spine instrumentation

Arthrodesis

Peripheral Nerve

Peripheral nerve tumors

Entrapment neuropathies

Autoimmune and inflammatory disorders

Infection

Cranial

Spine

Functional Neurosurgery

Epilepsy surgery

Deep brain stimulation

Trigeminal neuralgia

Stereotactic radiosurgery

Arteriovenous malformations

Vestibular schwannomas

Intracranial metastases

Congenital and developmental anomalies

Dysraphism

Spinal bifida occulta

Spinal bifida with myelomeningocele

Encephalocele

Craniosynostosis

Hydrocephalus

Chiari I malformation