Egyptian Board Neurosurgery flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Monro-Kellie doctrine

The intracranial volume is fixed by the rigid skull; brain, blood and CSF volumes must sum within that space, so an increase in one compartment raises intracranial pressure unless another decreases.

Epidural haematoma

A collection between skull and dura, usually from middle meningeal artery injury, appearing biconvex on CT, bounded by sutures, and classically preceded by a lucid interval.

Subdural haematoma

A crescent-shaped collection between dura and arachnoid from torn bridging veins; it crosses sutures but not the midline and is common in elderly and alcoholic patients.

Glasgow Coma Scale

A 3-15 score combining eye (1-4), verbal (1-5) and motor (1-6) responses; the motor component carries the strongest prognostic value in traumatic brain injury.

Cushing triad

Hypertension with widened pulse pressure, bradycardia and irregular respiration; a late sign of raised intracranial pressure reflecting brainstem compression.

Cerebral perfusion pressure

Mean arterial pressure minus intracranial pressure; normally 60-70 mmHg in adults and maintained within that range to preserve cerebral blood flow after injury.

Cerebral autoregulation

The ability of cerebral vasculature to maintain constant blood flow across mean arterial pressures of roughly 50-150 mmHg; it is impaired in severe trauma and ischaemia.

Glioblastoma

A WHO grade 4 IDH-wildtype astrocytic tumour with necrosis and microvascular proliferation; treated by maximal resection followed by radiotherapy with temozolomide.

Oligodendroglioma

An IDH-mutant, 1p/19q-codeleted glioma, usually frontal and calcified, grade 2 or 3, with better prognosis and greater chemosensitivity than astrocytic tumours.

Meningioma

An extra-axial dural-based tumour, typically benign and showing a dural tail with hyperostosis; grade 2-3 lesions show brain invasion or high mitotic activity.

Vestibular schwannoma

A benign CN VIII sheath tumour in the cerebellopontine angle causing unilateral sensorineural hearing loss and tinnitus; MRI shows widening of the internal acoustic meatus.

Spetzler-Martin grading

A 1-5 scale for arteriovenous malformations based on size, eloquent location and deep venous drainage; higher grades carry greater surgical risk.

Nimodipine in SAH

Oral nimodipine 60 mg every four hours for 21 days reduces delayed cerebral ischaemia and poor outcome after aneurysmal subarachnoid haemorrhage.

Cauda equina syndrome

Bilateral leg pain, saddle anaesthesia and bladder or bowel dysfunction from lumbosacral root compression; requires urgent MRI and decompression to prevent permanent deficit.

Neurogenic claudication

Leg pain and weakness on walking from lumbar canal stenosis, relieved by flexion or sitting (shopping-cart sign), unlike vascular claudication relieved by standing still.

Myelomeningocele

A neural tube defect with herniated meninges and cord through a posterior vertebral defect; associated with Chiari II malformation and hydrocephalus, requiring early surgical closure.

Chiari I malformation

Herniation of cerebellar tonsils more than 5 mm below the foramen magnum, often presenting with cough headache and syringomyelia, sometimes requiring decompression.

Dandy-Walker malformation

Cystic dilatation of the fourth ventricle with cerebellar vermis hypoplasia and an enlarged posterior fossa; hydrocephalus is common and shunting may be needed.

Normal pressure hydrocephalus

A triad of gait disturbance, urinary incontinence and cognitive decline with ventricular enlargement but normal CSF pressure; large-volume lumbar puncture predicts shunt response.

Endoscopic third ventriculostomy

A CSF diversion procedure creating a stoma in the third ventricle floor; indicated for obstructive hydrocephalus such as aqueductal stenosis, with success in about 70-80%.

CSF beta-2 transferrin

A protein found almost exclusively in CSF; its detection in nasal or ear fluid confirms a CSF leak after skull base surgery or trauma.

Deep brain stimulation

Implanted electrodes deliver adjustable high-frequency stimulation; subthalamic nucleus or globus pallidus internus targets treat Parkinson disease, and ventral intermediate thalamus treats tremor.

Trigeminal neuralgia

Paroxysmal lancinating facial pain in trigeminal distribution; carbamazepine is first-line, and microvascular decompression offers durable relief when a vessel compresses the nerve.

Mesial temporal sclerosis

Hippocampal atrophy with T2 hyperintensity, the most common cause of medically refractory focal epilepsy; anterior temporal lobectomy achieves seizure freedom in most selected patients.

Status epilepticus

Continuous seizure activity or recurrent seizures without recovery; treated with benzodiazepines first, then intravenous antiepileptic drugs, and anaesthetic coma if refractory.

Erb palsy

Upper brachial plexus injury (C5-C6) causing loss of shoulder abduction and elbow flexion with the arm internally rotated, the classic waiter's tip posture.

Carpal tunnel syndrome

Median nerve compression at the wrist causing nocturnal pain, thenar wasting and positive Tinel or Phalen tests; confirmed by nerve conduction studies.

Cerebral salt wasting

Hypovolaemic hyponatraemia after subarachnoid haemorrhage or brain injury from renal sodium loss; treated with isotonic saline, unlike SIADH which is treated with fluid restriction.

Decompressive craniectomy

Removal of a skull vault segment to allow brain swelling and lower intracranial pressure; used for refractory intracranial hypertension after trauma or malignant middle cerebral artery infarction.

Informed consent

Voluntary agreement by a patient with capacity after disclosure of diagnosis, proposed procedure, material risks, benefits and alternatives, documented in the medical record.

GRADE system

A framework rating quality of evidence (high to very low) and strength of recommendations (strong or weak), separating evidence certainty from clinical guidance.

DWI restricted diffusion

High signal on diffusion-weighted imaging with low apparent diffusion coefficient, indicating acute infarction, abscess or highly cellular tumour; distinguishes acute from chronic lesions.