Neurosurgery Board Review Questions and Answers for Self-Assessment Third Edition Cargill H. Alleyne Jr., MD Professor and Marshall Allen Distinguished Chairman Residency Program Director Department of Neurosurgery Medical College of Georgia at Georgia Regents University Augusta, Georgia M. Neil Woodall, MD Chief Resident Department of Neurosurgery Medical College of Georgia at Georgia Regents University Augusta, Georgia Jonathan Stuart Citow, MD, FACS Chief of Neurosurgery Advocate Condell Medical Center Libertyville, Illinois Assistant Clinical Professor of Neurosurgery Rosalind Franklin University Medical School North Chicago, Illinois and President of the American Center for Spine and Neurosurgery Libertyville, Illinois 268 illustrations Thieme New York · Stuttgart · Delhi · Rio de Janeiro Executive Editor: Timothy Y. Hiscock Important note: Medicine is an ever-changing science Associate Managing Editor: Kenneth Schubach undergoing continual development. Research and Managing Editor: Elizabeth Palumbo clinical experience are continually expanding our Director, Editorial Services: Mary Jo Casey knowledge, in particular our knowledge of proper treat- Production Editor: Heidi Grauel ment and drug therapy. Insofar as this book mentions International Production Director: Andreas Schabert any dosage or application, readers may rest assured that Vice President, Editorial and E-Product Development: the authors, editors, and publishers have made every Vera Spillner e ort to ensure that such references are in accordance International Marketing Director: Fiona Henderson with the state of knowledge at the time of produc- International Sales Director: Louisa Turrell tion of the book. Director of Sales, North America: Mike Roseman Senior Vice President and Chief Operating O cer: Nevertheless, this does not involve, imply, or express Sarah Vanderbilt any guarantee or responsibility on the part of the President: Brian D. Scanlan publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is Library of Congress Cataloging-in-Publication Data requested to examine carefully the manufacturers’ lea ets accompanying each drug and to check, if Alleyne, Cargill H., author. necessary in consultation with a physician or specialist, Neurosurgery board review : questions and answers whether the dosage schedules mentioned therein or for self-assessment / Cargill Alleyne, M. Neil Woodall, the contraindications stated by the manufacturers Jonathan Citow. — Third edition. di er from the statements made in the present book. p. ; cm. Such examination is particularly important with drugs Includes bibliographical references and index. that are either rarely used or have been newly released ISBN 978-1-62623-104-7 — ISBN 978-1-62623-105-4 on the market. Every dosage schedule or every form I. Woodall, M. Neil, author. II. Citow, Jonathan Stuart, of application used is entirely at the user’s own risk author. III. Title. and responsibility. The authors and publishers request [DNLM: 1. Neurosurgery—Examination Questions. WL 18.2] every user to report to the publishers any discrepancies RD593 or inaccuracies noticed. If errors in this work are found 617.4'80076—dc23 2015028124 after publication, errata will be posted at www.thieme. com on the product description page. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though speci c reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. Copyright © 2016 Thieme Medical Publishers, Inc. Thieme Publishers New York 333 Seventh Avenue, New York, NY 10001 USA 1 800 782 3488, [email protected] Thieme Publishers Stuttgart Rüdigerstrasse 14, 70469 Stuttgart, Germany 1 49 [0]711 8931 421, [email protected] Thieme Publishers Delhi A-12, Second Floor, Sector-2, Noida-201301 Uttar Pradesh, India 1 91 120 45 566 00, [email protected] Thieme Publishers Rio de Janeiro, Thieme Publicações Ltda. Edifício Rodolpho de Paoli, 25º andar Av. Nilo Peçanha, 50 – Sala 2508 Rio de Janeiro 20020-906 Brasil +55 21 3172 2297 Cover design: Thieme Publishing Group Typesetting by: Grauel Group This book, including all parts thereof, is legally protected Printed in the United States by Sheridan Books, Inc. 5 4 3 2 1 by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation, ISBN 978-1-62623-104-7 without the publisher’s consent, is illegal and liable to prosecution. This applies in particular to photostat Also available as an e-book: reproduction, copying, mimeographing, preparation of eISBN 978-1-62623-105-4 micro lms, and electronic data processing and storage. This book is dedicated to my wife, Audrey, and children, Nathan and Nicole, whose love and support keep me grounded; my parents, Cargill Sr. and Linnette, and sister, Carlin, who taught me the meaning of family; and to the many residents with whom I have worked over the years. Cargill H. Alleyne Jr., MD To my wife, Anneliese, my son, Art, and my parents, James and Linda, for their uncon- ditional love and support. M. Neil Woodall, MD This book is dedicated to my three most interesting children, Benjamin Joseph, Emma Caroline, and Harrison Atticus Chamberlain. Hopefully when you each join the clan of neurosurgeons (no pressure there...), you will correct any inaccuracies we have made here in this text, just as you are so wont to do with anything I touch at home. Jonathan S. Citow, MD v Co nte nts Foreword to the Third Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Foreword to the Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .x Preface to the Third Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Preface to the Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii Preface to the First Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii 1A. Neurosurgery – 4C. Neurobiology – Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Answers and Explanations . . . . . . . . . . . . . . . . . . . . . . .189 1B. Neurosurgery – Answer Key . . . . . . . . . . . . . . . . . . . . . . . . .25 5A. Neuropathology – Questions . . . . . . . . . . . . . . . . . . . . . . . . . .207 1C. Neurosurgery – Answers and 5B. Neuropathology – Explanations . . . . . . . . . . . . . . . . . . . . . . . .28 Answer Key . . . . . . . . . . . . . . . . . . . . . . . .248 2A. Clinical Neurology – 5C. Neuropathology – Questions . . . . . . . . . . . . . . . . . . . . . . . . . . .55 Answers and Explanations . . . . . . . . . . . . . . . . . . . . . . .251 2B. Clinical Neurology – Answer Key . . . . . . . . . . . . . . . . . . . . . . . . .80 6A. Neuroradiology – Questions . . . . . . . . . . . . . . . . . . . . . . . . . .294 2C. Clinical Neurology – Answers and 6B. Neuroradiology – Explanations . . . . . . . . . . . . . . . . . . . . . . . .84 Answer Key . . . . . . . . . . . . . . . . . . . . . . . .330 3A. Neuroanatomy – 6C. Neuroradiology – Questions . . . . . . . . . . . . . . . . . . . . . . . . . .110 Answers and Explanations . . . . . . . . . . . . . . . . . . . . . . .332 3B. Neuroanatomy – Answer Key . . . . . . . . . . . . . . . . . . . . . . . .136 7A. Clinical Skills/Critical Care – Questions . . . . . . . . . . . . . . . . . . .368 3C. Neuroanatomy – Answers and 7B. Clinical Skills/Critical Explanations . . . . . . . . . . . . . . . . . . . . . . .140 Care – Answer Key . . . . . . . . . . . . . . . . . .382 4A. Neurobiology – 7C. Clinical Skills/Critical Questions . . . . . . . . . . . . . . . . . . . . . . . . . .169 Care – Answers and Explanations . . . . . . . . . . . . . . . . . . . . . . .385 4B. Neurobiology – Answer Key . . . . . . . . . . . . . . . . . . . . . . . .186 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403