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Ebook Neurosurgery rounds - Questions and answers: Part 2

(BQ) Part 2 book “Neurosurgery rounds - Questions and answers” has contents: Clinical neurosciences, cranial neurosurgery, spine, peripheral nerves, neurology, neuroradiology, congenital and pediatric, spinal anatomy and surgical technique, congenital and pediatric, and other contents. | 5  Cranial Neurosurgery General History and Physical Examination Techniques Operative Anatomy Preoperative Assessment Trauma and Emergencies Trauma Emergencies Neoplasms Endocrine Radiation Therapy Infections Vascular Congenital and Pediatric Pain and Functional Cases p. 154 p. 154 p. 163 p. 170 p. 173 p. 175 p. 175 p. 181 p. 187 p. 207 p. 213 p. 215 p. 218 p. 240 p. 252 p. 255 153 154  II  Clinical Neurosciences General ■ History and Physical Examination 1. What is the most common type of headache? Tension headache 2. What lesions can produce a head tilt? Trochlear (IVth) nerve palsy, anterior vermis lesion, tonsillar herniation. In myasthenia gravis, the head tilts back.1 3. What is the term for the vermicular movement of the face in a patient with pontine demyelination? Myokymia2 4. What disorders can benefit from deep brain stimulation (DBS) of the ventral intermediate (VIM) thalamic nucleus? Essential tremor and parkinsonian tremor3,4 5. What region of the internal capsule may be affected in a patient with dysarthria and clumsy-hand syndrome?5 The genu 6. Dilute pilocarpine (0.1–0.125%) may constrict what type of pupil? An Adie pupil. This is possibly because of denervation supersensitivity as the normal pupil reacts only to 1% pilocarpine. A pharmacologic pupil (dilated for the purpose of examination by an ophthalmologist) will not constrict with 1% pilocarpine; however, a pupil that is dilated from a compressive third cranial nerve palsy may constrict with 1% pilocarpine.6 7. What is the term given when the consensual light ­reflex is stronger than the direct light reflex? Afferent pupillary defect. The lesion is ipsilateral to the side of the impaired direct reflex.7 8. What is the most common cause of spontaneous diplopia in middle-aged people? Orbital Graves disease is the most common cause of spontaneous diplopia in this age group. It can present with nor- 5  Cranial Neurosurgery: General  155 mal thyroid function tests. The .