MCQ Neurosurgery Congenital malformation

• Type I - Displacment of cerebellar tonsil into cervical canalQ
• Type II - Lesion represents an anomaly of the hindbrain

Projects into pelvis through a defect in the sacrumQ

• Cystic expansion of the 4th ventricle in the posterior fossa and midline cerebellar hypoplasiaQ
• Results from a developmental failure of the roof of the 4th ventricleQ

Lumbosacral region (75%)Q

• −−Abnormal gait (ataxic or apractic)Q
• −−DementiaQ (usually mild to moderate, with an emphasis on executive impairment)
• −−Urinary urgency or incontinenceQ

Median neuropathyQ

• • Main symptom: Intermittent numbness of the thumb, index, long and radial half of the ring finger. Numbness often occurs at nightQ.
• • Atrophy of thenar eminence and weakness of palmar abduction. Q
• • Pain is primarily numbness that is so intense that it wakes one from sleepQ.

Percussion over the carpal tunnel

Reproduction of paraesthesia with full wrist flexion

Transverse carpal ligamentQ (creating space for the nerve)

• • Reversible physiological nerve conduction blockQ
• • Seen in crutch palsy, tourniquet palsy, and Saturday night palsyQ

Loss of conduction due to axonal interruption

Complete division of nerveQ

1 mm/dayQ.

Radial nerve (best)Q >Median nerve >Ulnar nerve >Peroneal nerve >Sciatic and femoral nerve (worst prognosis)Q

Thoracic origin of a sympathetic supply to the upper limbQ

Anterior temporal lobectomyQ

• • Kernohan’s notch is a cerebral peduncle indentation associated with some forms of transtentorial herniation (uncal herniation)Q.
• • Compression of the contralateral cerebral peduncle against the free edge of the tentorium (Kernohan’s notch) causes an ipsilateral hemiparesis with ipsilateral 3rd nerve palsyQ.

Lateral displacement of the midbrain may compress the opposite cerebral peduncle, producing a Babinski’s sign and hemiparesis contralateral to the original hemiparesis