Altered Neurologic Status

Surgery

Assumptions

Students understand basic central and peripheral neurological anatomy and function, including: cross sectional anatomy, histology, gross anatomy, and sensory/motor endpoints.

Knowledge Objectives

Through their reading and patient care experiences, at the end of the rotation students should be able to:

Describe the physiology of intracerebral pressure (ICP) and cerebral perfusion pressure (CPP), including the effects of blood pressure, ventilatory status, and fluid balance on ICP and CPP.
Recognize the Cushing reflex and its clinical importance (brain herniation).
Discuss the diagnosis and management of the patient with headaches.
Describe the signs, etiology and treatment of intracranial hemorrhage (subarachnoid hemorrhage and intracerebral hemorrhage).
Describe the relative incidence and location of the most common brain tumors, their clinical manifestations, their diagnosis, and general treatment strategies.
Differentiate brain abscesses from tumors, and discuss the treatment of intracranial infections.
Describe the evaluation and management of a patient with an acute focal neurologic deficit.
Differentiate TIA, RIND, and CVA.
Differentiate anterior vs. posterior circulation symptoms.
Outline the diagnostic tests and monitoring of carotid occlusive disease, including role of
angiography and noninvasive methods.
Discuss medical vs. surgical management of carotid artery disease.
Describe the signs, symptoms, and treatment of common peripheral nerve entrapment syndromes, as well as other nerve injuries.
Describe the presentation and management of hydrocephalus.
Compare and contrast adult and pediatric hydrocephalus.
Discuss the role of surgery in the management of pain, movement, and seizure disorders.
Discuss the importance of blood pressure control in the prevention of stroke.
Discuss the importance of early diagnosis and treatment in subarachnoid hemorrhage.
Discuss the importance of appropriate diagnosis, management, referral in the prevention of complications of carotid occlusive disease.