Neurosurgery and Cranial Anatomy

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What is the main principle of the Monro-Kellie doctrine?

The volume of the cranial cavity increases with age

The brain tissue, CSF, and blood vessels have a variable volume

The cranial cavity has a fixed volume composed of brain tissue, CSF, and blood vessels (correct)

The intravascular blood is the largest component of the cranial cavity

What is the rate of cerebrospinal fluid production?

10 to 15 mL/hr

15 to 20 mL/hr (correct)

20 to 25 mL/hr

5 to 10 mL/hr

What happens when there is an elevation in the volume of one compartment in the cranial cavity?

The volume of the other compartments remains the same

The intracranial pressure decreases

The volume of the other compartments increases

The volume of one or more of the other compartments can be reduced (correct)

What is the composition of the cranial cavity?

Brain tissue, CSF, and blood vessels Signup and view all the answers

What is the consequence of an increase in one component of the cranial cavity?

An equal and opposite decrease in one or both of the remaining components Signup and view all the answers

What is the purpose of the Monro-Kellie doctrine?

To explain the relationship between the components of the cranial cavity and the intracranial pressure Signup and view all the answers

Cerebral venous thrombosis occurs more frequently in which gender?

Women Signup and view all the answers

Which of the following symptoms is NOT associated with cerebral venous thrombosis?

Fever Signup and view all the answers

What is the importance of an elevated D-dimer level in diagnosing cerebral venous thrombosis?

It supports the diagnosis of cerebral venous thrombosis Signup and view all the answers

What imaging modality is used to demonstrate hyperdensities along the left tentorium and involving the left sigmoid sinus?

Computed Tomogram (CT) without intravenous contrast Signup and view all the answers

In which age group should cerebral venous thrombosis be considered in patients with acute, subacute, or chronic headache with unusual features?

Patients 50 years of age Signup and view all the answers

What is a characteristic of cerebral venous thrombosis on imaging?

Hyperdensities along the left tentorium Signup and view all the answers

What happens when tissue demand exceeds autoregulation or CBF declines for pathologic reasons?

The arteriovenous oxygen difference extraction increases Signup and view all the answers

What is the formula for calculating cerebral perfusion pressure?

CPP = MAP - ICP Signup and view all the answers

What percentage of trauma deaths are caused by head injury?

50% Signup and view all the answers

What is the primary cause of primary injury in traumatic brain injury?

External physical forces applied to the head Signup and view all the answers

What is the estimated number of head injury cases every year?

500,000 to 1 million Signup and view all the answers

What is the percentage of head injuries classified as moderate to severe?

20% Signup and view all the answers

What happens to CSF production when there is an increase in intracranial backpressure?

It remains unaffected Signup and view all the answers

What is the normal range of CBF in mL/100 g of brain tissue per minute?

30 to 100 Signup and view all the answers

What determines the blood flow to a particular area of the brain?

Metabolic demand from neuronal activity Signup and view all the answers

What is the effect of an elevated or decreased arterial PCO2 on the autoregulation curve?

It shifts the curve as indicated Signup and view all the answers

What happens to the autoregulation curve in the setting of traumatic brain injury?

It becomes more pronounced Signup and view all the answers

What is the purpose of autoregulation in the brain vasculature?

To match blood flow to tissue metabolic demand Signup and view all the answers

What is the goal of treatment in traumatic brain injury?

To maintain CPP at or above 70 mmHg Signup and view all the answers

What is the predictor of poor outcome in traumatic brain injury?

SBP < 90 mmHg or a PaO2 < 60 mmHg Signup and view all the answers

What is the treatment approach for epidural and subdural hematomas?

Craniotomy centered on the clot Signup and view all the answers