NEUROSURGERY PRACTICE QUESTIONS AND ANSWERS Second Edition NEUROSURGERY PRACTICE QUESTIONS AND ANSWERS Second Edition Mark R. Shaya, MD, FACS Founder and President Neurosurgical Institute of Florida Miami, Florida Cristian Gragnaniello, MD, PhD, MSurg, MAdvSurg, FICS Surgical Director Harvey H. Ammerman Microsurgical Laboratory Department of Neurosurgery George Washington University Washington, DC Remi Nader, MD, CM, FRCS(C), FAANS, FACS Founder and President Texas Center for Neurosciences Houston, Texas Executive Editor: Timothy Y. Hiscock Important note: Medicine is an ever-changing sci- Managing Editor: Sarah Landis ence undergoing continual development. Research Director, Editorial Services: Mary Jo Casey and clinical experience are continually expanding Assistant Managing Editor: Nikole Connors our knowledge, in particular our knowledge of prop- Production Editor: Sean Woznicki er treatment and drug therapy. Insofar as this book International Production Director: Andreas Schabert mentions any dosage or application, readers may rest Vice President, Editorial and E-Product Development: assured that the authors, editors, and publishers have Vera Spillner made every eff ort to ensure that such references are International Marketing Director: Fiona Henderson in accordance with the state of knowledge at the International Sales Director: Louisa Turrell time of production of the book. Director of Sales, North America: Mike Roseman Nevertheless, this does not involve, imply, or express Senior Vice President and Chief Operating Offi cer: any guarantee or responsibility on the part of the Sarah Vanderbilt publishers in respect to any dosage instructions and President: Brian D. Scanlan forms of applications stated in the book. Every user is requested to examine carefully the manufactur- Library of Congress Cataloging-in-Publication Data ers’ leafl ets accompanying each drug and to check, if Names: Shaya, Mark, author. | Gragnaniello, Cristian, author. necessary in consultation with a physician or special- | Nader, Remi, author. ist, whether the dosage schedules mentioned therein Title: Neurosurgery practice questions and answers / or the contraindications stated by the manufacturers Mark R. Shaya, Cristian Gragnaniello, Remi Nader. diff er from the statements made in the present book. Description: 2nd edition. | New York : Thieme, [2016] Such examination is particularly important with drugs Identifi ers: LCCN 2016023304 | ISBN 9781626233478 that are either rarely used or have been newly released Subjects: | MESH: Neurosurgical Procedures | Nervous on the market. Every dosage schedule or every form of System Diseases--surgery | Neurosurgery--methods | application used is entirely at the user’s own risk and re- Examination Questions sponsibility. The authors and publishers request every Classifi cation: LCC RC356 | NLM WL 18.2 | DDC 616.80076-- user to report to the publishers any discrepancies or in- dc23 LC record available at https://lccn.loc.gov/2016023304 accuracies noticed. If errors in this work are found after publication, errata will be posted at www.thieme.com © 2016 Thieme Medical Publishers, Inc. on the product description page. Thieme Publishers New York Some of the product names, patents, and registered 333 Seventh Avenue, New York, NY 10001 USA designs referred to in this book are in fact registered +1 800 782 3488, [email protected] trademarks or proprietary names even though spe- cifi c reference to this fact is not always made in the Thieme Publishers Stuttgart text. Therefore, the appearance of a name without Rüdigerstrasse 14, 70469 Stuttgart, Germany designation as proprietary is not to be construed as a +49 [0]711 8931 421, [email protected] representation by the publisher that it is in the public Thieme Publishers Delhi domain. A-12, Second Floor, Sector-2, Noida-201301 Uttar Pradesh, India +91 120 45 566 00, [email protected] Thieme Publishers Rio de Janeiro, Thieme Publicações Ltda. Edifício Rodolpho de Paoli, 25° andar Av. Nilo Peçanha, 50 – Sala 2508, Rio de Janeiro 20020-906 Brasil +55 21 3172-2297 / +55 21 3172-1896 Cover design: Thieme Publishing Group Typesetting by DiTech Process Solutions This book, including all parts thereof, is legally pro- tected by copyright. Any use, exploitation, or com- Printed in the United States of America by mercialization outside the narrow limits set by cop- S heridan Press 5 4 3 2 1 yright legislation, without the publisher’s consent, is illegal and liable to prosecution. This applies in par- ISBN 978-1-62623-347-8 ticular to photostat reproduction, copying, mimeo- Also available as an e-book: graphing, preparation of microfi lms, and electronic eISBN 978-1-62623-364-5 data processing and storage. Dedicated to those neurosurgeons without the titles of academia or positions in societies, but oftentimes with the most skill, wisdom, and experience: the private practice neurosurgeon. v Content Foreword viii Preface ix Questions 1 Answers 168 vii Foreword Dr. Mark Shaya, Dr. Remi Nader, and Dr. Cristian Gragnaniello have produced a beautiful, balanced and thorough tome that addresses a growing need in neurosurgery. This second edition of Neurosurgery Practice Questions and An- swers is a valuable tool for continuing education and, more importantly, a tool for board and maintenance of certifi cation examination preparation. They present over 800 prototypical board examination questions and answers fea- turing in-depth explanations for answers. With the relentless and endless perpetual increase in the body of neurosurgi- cal knowledge, neurosurgeons are faced with incredible educational diffi cul- ties. This book will most certainly serve as a unique and valid mechanism to help address this challenge. Practicing neurosurgeons can refer to this book as a simple refresher. It most certainly will be extraordinarily useful as a preparation tool for maintenance of certifi cation examinations. Residents in training can similarly use this book as a tool for knowledge acquisition and for board preparation. This book can also eff ectively serve as a platform for the pursuit of knowledge; the more challenging questions in the book will help the reader to identify knowledge gaps where further study is needed. The question topics are diverse and cover the entire fi eld of neurosurgery, including all sub-disciplines. In addition, the questions blanket the associated basic science fi elds—these include pharmacology, physiology, anatomy, and pathology. Finally, imaging and neurology questions broaden the scope of the book even further, thus making it truly relevant to board and mainte- nance of certifi cation examination preparation In summary, this book represents a n inexpensive and very valuable tool for neurosurgery education. It belongs on the shelf of every neurosurgeon and neurosurgery trainee. Edward Benzel, MD Chairman, Department of Neurosurgery Neurological Institute, Cleveland Clinic Cleveland, Ohio viii