Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Test Taking Tips Make sure that you are familiar with the Glasgow Coma Score prior to the test. Review the neurosurgery section in the trauma chapter, since most of the neurosurgical content is tied in with trauma scenarios. +++ What components are present in the cranium? ++ Brain tissue, cerebrospinal fluid (CSF), blood vessels and blood volume, pathologic volume (e.g., neoplasm, hematoma, abscess, etc.) +++ What may cause an increase in the brain tissue component (not including neoplasms)? ++ Edema, inflammatory, perineoplastic, vasogenic +++ What can be given to decrease swelling due to edema? ++ Mannitol, hypertonic saline +++ What can be given to decrease the brain tissue component if swelling is caused by inflammation or perineoplastic syndrome? ++ Steroids +++ What can be done to decrease the blood volume component? ++ Hyperventilation, diuretics, head elevation, remove venous obstruction +++ What can be done to decrease the CSF component? ++ Drainage (either external or internal such as a VP shunt), acetazolamide (temporary), steroids (temporary) +++ What can be done to decrease volume due to a mass lesion? ++ Evacuation or removal of the cause of the mass lesion +++ What is the Monro-Kelly doctrine? ++ The total volume of the cranial vault is fixed, and thus an increase in one component must be offset by a decrease in another component +++ True or False: CSF production rate is affected by intracranial pressure (ICP) ++ False. CSF production rate is constant and is not affected by “back pressure.” +++ What is the site of CSF production? ++ The arachnoid granulations +++ What is the name of the process that maintains cerebral blood flow at a constant rate despite changes in systemic blood pressure? ++ Autoregulation +++ Define cerebral perfusion pressure: ++ Mean arterial pressure (MAP) – ICP +++ Why do older people tend to be more tolerant of mass lesions? ++ They tend to have larger ventricles, which are more tolerant of compression than brain tissue +++ What is a raised ICP with no mass lesion termed? ++ Pseudotumor cerebri or idiopathic intracranial hypertension +++ What is increased ventricular volume without increased intracranial pressure called? ++ Normal pressure hydrocephalus +++ What is a failure of proper capillary formation termed? ++ Arteriovenous malformation (AVM) +++ What is the risk of hemorrhage associated with an AVM? ++ 4% per year +... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.