[10.11a] Surgical Interventions in Neurology (Part 1) V2.1.pdf

Neurosurgery

What branch of medicine deals with the diagnosis and treatment of patients with injury to or diseases of the brain, spinal cord, and peripheral nerves?

Sophisticated tools

What is required for neurosurgery to be able to enter the brain?

Higher mortality and morbidity

How do procedures like brain surgery compare to other cutting specialties in terms of risk?

Microscope and exoscope

What two tools are coupled to visualize minuscule brain parts in greater detail?

Neuroanesthesiologists, nurses, and neurophysiologists

Besides surgeons, what three other specialties are required in a neurosurgical suite?

Bone, skin, and dura

The brain is enclosed and covered by which three specific layers?

Precision

What is required to locate a particular area of the brain because you cannot simply peel back the surface?

Metopic suture

Which suture is present in a pediatric skull but absent in adults?

Pterion

What is the junction point where the frontal, parietal, temporal, and sphenoid bones meet?

Wings

What is the Greek meaning of the word pterion?

Asterion

What is the convergence point of the lambdoid, parietotemporal, and parietomastoid sutures?

Greater and lesser wings

The sphenoid bone is made up of what two specific parts?

Temporal bone

Which bone houses the ossicles and the bony labyrinth of the ear?

Frontal bone

Which bone of the calvarium is located at the anterior part?

Parietal bone

Which bone of the calvarium is located at the superior and lateral parts?

Occipital bone

Which bone of the calvarium is located at the posterior part?

Sphenoid bone

Which bone of the calvarium is color-coded yellow in the source diagrams?

Cribriform plate

Through which structure do the olfactory nerves or CN I pass?

Superior orbital fissure

Which opening transmits CN III, CN IV, CN VI, and the ophthalmic branch of CN V?

V1

What is the shorthand for the ophthalmic branch of the trigeminal nerve?

Foramen rotundum

Which opening transmits the maxillary branch of the trigeminal nerve?

V2

What is the shorthand for the maxillary branch of the trigeminal nerve?

Foramen ovale

Which opening transmits the mandibular branch of the trigeminal nerve?

V3

What is the shorthand for the mandibular branch of the trigeminal nerve?

Carotid canal

Through which canal does the carotid artery pass?

Internal acoustic meatus

Which opening transmits the facial and vestibulocochlear nerves?

CN VII and VIII

What are the two cranial nerves associated with the internal acoustic meatus?

Jugular foramen

Which opening transmits the glossopharyngeal, vagus, and accessory nerves?

CN IX, X, and XI

What are the three cranial nerves associated with the jugular foramen?

Hypoglossal canal

Which opening transmits the hypoglossal nerve?

CN XII

What is the shorthand for the hypoglossal nerve?

Bregma

What is the name for the top of the coronal suture at the junction with the sagittal suture?

Five

The cerebrum is arbitrarily divided into how many lobes?

Frontal, parietal, temporal, occipital, and insula

What are the five lobes of the brain?

Superior, middle, and inferior

The frontal lobe is divided into which three gyri?

Two

How many sulci are found on the lateral surface of the frontal lobe?

Superior, middle, and inferior

The temporal lobe is divided into which three gyri?

Island of Reil

What is another name for the insula lobe?

Sylvian fissure, callosal sulcus, parieto-occipital sulcus, and collateral sulcus

What are the four main sulci that are 100 percent continuous?

Central sulcus

Which structure limits or separates the parietal lobe and the frontal lobe?

Posterior ramus of the Sylvian fissure

Which structure separates the parietal lobe and the temporal lobe?

Lateral parietotemporal line

Which line separates the parietal lobe and the occipital lobe?

Preoccipital notch

The lateral parietotemporal line runs from the parieto-occipital sulcus to which landmark?

Temporo-occipital line

Which line runs from the Sylvian fissure to the midpoint of the lateral parietotemporal line?

Superior and inferior frontal sulci

What are the two main sulci of the frontal lobe?

Superior and inferior parietal lobules

The intraparietal sulcus subdivides the parietal lobe into which two parts?

Supramarginal gyrus

Which gyrus cuts the end of the Sylvian fissure?

Gerstmann syndrome

A lesion in the dominant hemisphere of the supramarginal gyrus leads to what syndrome?

Acalculia, finger agnosia, agraphia, and left-right disorientation

What are the four symptoms of Gerstmann syndrome?

Angular gyrus

Which gyrus cuts the superior temporal sulcus?

Pars orbitalis, pars triangularis, and pars opercularis

What are the three subdivisions of the inferior frontal gyrus?

Broca's area

What area is formed by the pars triangularis and pars opercularis?

Left

In 95 percent of people, which inferior frontal gyrus is an important landmark?

Expressive or non-fluent aphasia

A lesion in Broca's area leads to what type of aphasia?

Anterior horizontal, anterior ascending, and posterior

What are the three rami of the Sylvian fissure?

Pli di passage

What structure at the end of the Sylvian fissure connects the precentral to the postcentral gyrus?

Omega sign

What radiological morphological marker represents the motor strip?

Superior frontal and precentral sulci

The omega sign is found at the intersection of which two sulci?

Precentral gyrus

Which gyrus often presents with the morphology of the letter omega?

Limb weakness

A lesion or tumor on the omega sign area will result in what?

Contralateral

Damaging the omega sign results in paralysis on which side of the body?

Temporal pole

Lesions in what part of the temporal lobe can lead to dyspnea?

Dyspnea

What is the term for difficulty breathing?

Interhemispheric fissure

What is the medial boundary of the parietal lobe?

Postcentral and intraparietal

What are the two sulci contained in the parietal lobe?

Superior parietal lobule

In which part of the parietal lobe can a lesion be made to enter the lateral ventricle because it is usually silent?

Supramarginal gyrus

Which gyrus is the continuation of the superior temporal gyrus?

Angular gyrus

Which gyrus is the continuation of the middle temporal gyrus?

Primary visual area

What area is carried by the medial occipital lobe?

Pyramid

What is the shape of the insula?

Transverse gyrus, accessory gyrus, and insular pole

The anterior surface of the insula is constituted by which three structures?

Cerebrospinal fluid

What do the ventricles of the brain hold?

Frontal horn, body, temporal horn, occipital horn, and atrium

What are the five components of the lateral ventricle?

Atrium

What is the intersection of the body, temporal horn, and occipital horn of the lateral ventricle?

Meningiomas

What type of tumor can specifically grow in the atrium of the lateral ventricle?

Frontal horn and body

In normal individuals, which are the only parts of the lateral ventricles that can be visualized?

Slit-like

How are the temporal and occipital horns described in normal individuals?

3rd ventricle

Which ventricle is described as having a chicken-like structure?

Aqueduct of Sylvius

What is the alternative name for the cerebral aqueduct?

Cerebral aqueduct

Which structure is described as the neck of the chicken?

4th ventricle

Which structure is described as the body of the chicken?

1 to 2 mm

What is the diameter of the cerebral aqueduct?

Congenital aqueductal stenosis

What congenital malfunction involves a narrowing that causes CSF pooling?

Macrocephaly

What is the medical term for the enlargement of a child's head due to hydrocephalus?

4th ventricle

If the obstruction is at the cerebral aqueduct, which ventricle remains normal in size?

Ventriculoperitoneal shunt

What procedure shunts CSF into the abdominal cavity?

Silastic catheter

What kind of catheter is used in a ventriculoperitoneal shunt?

ETV

What is the acronym for Endoscopic third ventriculostomy?

Prepontine cistern

In an ETV, an opening is made in the third ventricle to communicate with which cistern?

Communicating hydrocephalus

What type of hydrocephalus is caused by tuberculosis meningitis?

Non-communicating or obstructive

For which type of hydrocephalus is ETV effective?

Internal capsule

What white matter structure carries information past the basal ganglia?

Inferomedial

In what part of the cerebral hemisphere is the internal capsule found?

Caudate nucleus

Which subcortical structure is found anterior to the internal capsule?

Thalamus

Which subcortical structure is found posterior to the internal capsule?

Putamen

Which subcortical structure is found laterally to the internal capsule?

Thalamic glioma

What type of tumor can block the third ventricle and cause obstructive hydrocephalus?

Posterior limb

Which part of the internal capsule carries motor fibers?

Contralateral plegia

A hemorrhage in the posterior limb of the internal capsule will render the body into what?

Boomerang

What configuration does the internal capsule have on imaging?