外科：神外

21 flashcards · Other · by Wanying Koh

1. most common single-suture craniosynotosis

   sagittal suture

2. spine meningioma most commonly at?

   thoracic spine

3. most common lumbar stenosis level

   L4-5

4. most common nerve root compression level of cervical radiculopathy

   C6-7

5. odontoid fracture - most common type of non-union type 1/2/3?

   Type 2

6. tumor meta to spine most common at which part of spine?

   thoracic spine

7. HIVD most common at ?

   L4-5, L5-S1

8. ways to dec. intracranial pressure

   Dec brain bloodflow elevate head 30-45deg hyperventilation - dec. PaCO2 to 30-35mmHg (不要太低) Dec CSF lumbar puncture (temporary) ventricular CSF drainage - using VP shunt Dec brain metabolism hypothermia Dec brain tissue edema hyperosmotic diuresis - using mannitol, glycerol, furosemide Inc brain space craniectomy Dec inflammation *steroids (only for tumor related IICP)

9. located at intra/extradural? intra/extramedullary? neurofibroma astrocytoma schwannoma meningioma

   neurofibroma - intradural extramedullary astrocytoma - intra intra schwannoma - intra extra meningioma - intra extra

10. intradural vs. extradural tumor % intradural intramedullary intradural extramedullary %

    intradural tumors 45% intra intra 5% intra extra 40% extradural tumors 55%

11. most common brain tumors in children

    ependyma peripheral neuroectodermal tumor PNETS (<2yo 50%) medulloblastoma (5-7yo) craniopharyngioma (children/teens) germ cell tumor (10-12yo)

12. most common brain tumors in females

    schwannoma meningioma pseudotumor cerebri (obese young women)

13. most common brain tumors in males

    astrocytoma hemangioblastoma （mostly at cerebellum）

14. choroid plexus papilloma 發生 in which 族群 tumor located most commonly at which areas for each 族群

    children and adults 都可見 嬰兒發生率高 children - lat ventricle (1st, 2nd ventricle) adults - 4th ventricle

15. other brain malignancies that involve which ventricles ependyma craniopharyngioma

    ependyma - 4th ventricle craniopharyngioma - 3rd ventricle, sella turcica

16. Chiari malformation I - IV 之特性 most common most serious

    cerebellum 發育不良 most common - type I most serious - type III

17. Dx

    brain abscess double rim sign - outer rim hypodense, inner rim hyperdense (+ central area low intensity)

18. seizures caused by abnormal 放電 from R temporal lobe tx with highest cure

    ant. temporal lobectomy - 根除性治療 （直接切掉組織最有效）

19. SAH rebleeding or vasospasm occurs first? time point of occurrence

    rebleeding first - within 24 hrs of SAH vasospasm mostly occurs at 4-14 days after SAH (不會<3d)

20. blood vessels 受損 EDH SDH

    EDH - middle meningeal a. SDH - bridging v.

21. germinoma 好發族群 好發位置 F or M

    90% diagnosed in children <20yo pineal gland 50% F:M 1:1 // except for pineal germinomas M >>>> F