NEUROSURGICAL PROBLEMS

After discussing the topic with a Consultant Neurosurgeon has advised that you should reinforce your knowledge of some common problems in NSU: 

Brain tumours, Trauma, Intracranial bleeds, Hydrocephalus, Infection

Neurosurgery can seem quite complex - but remember that essentially the brain is a box and can only cope with so much pressure inside it before it pops open (or out down the foramen magnum...) - some light reading might be the Monro-Kellie doctrine.


There are very common symptoms and signs associated with increased ICP and you should know them all and why they are worrying. Nausea/vomitting, visual acuity changes, decreasing GCS (what is a Glasgow coma scale?), syncope and seizures.


    •    You should probably know what 'NIModipine' does in SAH and why it is used as a treatment. Why are IV fluids important in SAH and why is everyone on a NSU ward concerned over sodium levels?
    •    How do you treat chronic/acute hydrocephalus? What does it present with?
    •    What types of brain tumours can you name? Could you name a few as differentials?
    •    How would you deal with someone with a GCS of 3 in A&E who has just had their first seizure? Basic principles?