Disability Classification Statistics
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Questions and Answers

Who is the chapter dedicated to?

  • Dr. Sunit Das
  • Dr. Eric Massicotte
  • Dr. Todd Mainprize (correct)
  • Dr. Michael G. Fehlings

    • What is the topic of the section starting from page NS35?

  • Paediatric Neurosurgery
  • Intracranial Pathology
  • Basic Anatomy Review
  • Neurotrauma (correct)

    • What is discussed in the section on page NS4?

  • Intracranial Pathology
  • Neurotrauma
  • Basic Anatomy Review
  • Differential Diagnoses of Common Presentations (correct)

    • What is ICP an abbreviation for?

    <p>Intracranial Pressure</p> Signup and view all the answers

    Who are the associate editors of the chapter?

    <p>Ashmita Singh and Winston Li</p> Signup and view all the answers

    What is one of the topics discussed under Neurotrauma?

    <p>Head Injury</p> Signup and view all the answers

    Who are the EBM editors of the chapter?

    <p>Isra Hussien and Lisa Vi</p> Signup and view all the answers

    What is one of the topics discussed under Basic Anatomy Review?

    <p>Not mentioned in the text</p> Signup and view all the answers

    What percentage of patients in the control group had moderate severe disability?

    <p>32%</p> Signup and view all the answers

    In which group were infections more frequent?

    <p>Hemicraniectomy group</p> Signup and view all the answers

    What was the percentage of patients with severe disability in the hemicraniectomy group?

    <p>13%</p> Signup and view all the answers

    What was the outcome for 33% of patients in the control group?

    <p>Death</p> Signup and view all the answers

    What was the age of patients studied in this research?

    <p>&gt;60 yr</p> Signup and view all the answers

    What was more frequent in the control group?

    <p>Herniation</p> Signup and view all the answers

    What is the level of nerve root impingement depicted in the AP view of the cervical spine?

    <p>C4-5</p> Signup and view all the answers

    Which of the following arteries is NOT labeled in the diagram?

    <p>V</p> Signup and view all the answers

    At which vertebral level is the nerve root impingement depicted in the AP view of the lumbar spine?

    <p>L4-5</p> Signup and view all the answers

    How many nerve roots are depicted in the cervical spine diagram?

    <p>5</p> Signup and view all the answers

    What is the direction of the view depicted in the diagram?

    <p>Anterior-posterior</p> Signup and view all the answers

    Which of the following is a correct correspondence between the vertebral level and the nerve root?

    <p>C4-5 corresponds to nerve root C5</p> Signup and view all the answers

    How many levels of disc herniation are depicted in the diagram?

    <p>2</p> Signup and view all the answers

    Who is the original author of the diagram?

    <p>Caitlin O'Connell</p> Signup and view all the answers

    What is the purpose of the LP findings in the diagnostic process?

    <p>To rule out venous sinus thrombosis, mass, and infection</p> Signup and view all the answers

    What is the age range of 20% of the cases in the SAH group?

    <p>55-60 years old</p> Signup and view all the answers

    What is the significance of hyperdense blood in cisterns/fissures?

    <p>It is a sign of SAH</p> Signup and view all the answers

    What is the purpose of nimodipine in the conservative management of SAH?

    <p>To prevent vasospasm</p> Signup and view all the answers

    What is the significance of a papilledema grade improvement?

    <p>It is a sign of acetazolamide efficacy</p> Signup and view all the answers

    What is the significance of slit-like ventricles and distended perioptic subarachnoid space?

    <p>It is a normal MRI finding</p> Signup and view all the answers

    What is the mortality rate of SAH patients at 6 months with a drain?

    <p>8.6%</p> Signup and view all the answers

    What is the purpose of the MRI brain investigation in this study?

    <p>To rule out venous sinus thrombosis, mass, and infection</p> Signup and view all the answers

    What is the target pO2 level to prevent hypoxic brain injury?

    <p>60 mmHg</p> Signup and view all the answers

    What is the purpose of maintaining serum osmolarity between 315-320 mOsm/kg?

    <p>To osmotically drive fluid out of the brain</p> Signup and view all the answers

    What is the primary outcome measured in the study on patients with TBI and refractory intracranial hypertension?

    <p>Extended Glasgow Outcome Scale at 6 months</p> Signup and view all the answers

    What is the recommended dose of mannitol for osmol diuresis?

    <p>1-1.5 g/kg, then 0.25 g/kg q6h</p> Signup and view all the answers

    What is the effect of normocarbia on the brain?

    <p>It prevents vasodilation</p> Signup and view all the answers

    What is the mortality rate of patients treated with decompressive craniectomy compared to medical care?

    <p>Lower in decompressive craniectomy group</p> Signup and view all the answers

    What is the recommended systolic blood pressure to maintain in patients with TBI?

    <p>100 mmHg</p> Signup and view all the answers

    What is the alternative to mannitol for osmol diuresis?

    <p>Hypertonic saline 3%</p> Signup and view all the answers

    Study Notes

    Neurosurgery

    • Dedicated to Dr. Todd Mainprize, expert in teaching and development of this chapter

    Basic Anatomy Review

    • Relationship of nerve roots to vertebral level in the cervical and lumbar spine

    Intracranial Pathology

    • Intracranial pressure dynamics
    • ICP/Volume relationship
    • Cerebral blood flow
    • ICP measurement
    • Elevated ICP

    Trauma Assessment

    • Head injury
    • Brain injury
    • Spinal cord injury
    • Fractures of the spine
    • Neurologically determined death
    • Coma
    • Persistent vegetative state
    • Pediatric neurosurgery

    Management of Traumatic Brain Injury

    • Ventilate to pCO2 35-40 mmHg to prevent vasodilatation
    • Maintain pO2 >60 mmHg to prevent hypoxic brain injury
    • Osmolar diuresis with mannitol or hypertonic saline
    • Maintain systolic blood pressure >100 mmHg
    • Decompressive craniectomy for refractory intracranial hypertension

    Investigations

    • MRI brain (with and without contrast) to rule out venous sinus thrombosis, mass, infection, and hydrocephalus
    • LP findings: subarachnoid blood, crescentic mass, and bridging vessels

    Subarachnoid Hemorrhage (SAH)

    • Causes: trauma, spontaneous (aneurysms, idiopathic, AVM)
    • Characteristics: sudden onset, thunderclap headache, signs of increased ICP
    • Management: conservative, NPO, IV normal saline, ECG, Foley, BP 120-150, vasospasm prophylaxis (nimodipine)
    • Prognosis: 50% mortality; 30% of survivors have moderate-to-severe disability

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    Description

    Quiz on statistics related to disability classification, including percentages of patients in different categories.

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