Neurosurgery

A

• Acute Obstructive Hydrocephalus - Emergency

  Signs of raised intracranial pressure with ventricular enlargement require urgent CSF diversion with EVD or third ventriculostomy depending on cause.
• Acute Subdural Hematoma - Trauma Management

  Common in high velocity trauma and elderly on anticoagulants; reverse anticoagulation and evacuate with decompression when neurologic deterioration or mass effect.
• Aneurysmal Subarachnoid Hemorrhage - Initial Management

  Secure airway when needed, control pain and blood pressure, give nimodipine, treat hydrocephalus, and arrange early aneurysm securing by coiling or clipping.

B

• Brain Abscess - Neurosurgical Drainage Indications

  Focal infection requires antibiotics and often stereotactic aspiration or excision when large, multiloculated, posterior fossa, or failing medical therapy.

C

• Cauda Equina Syndrome - Urgent Decompression

  Saddle anesthesia, bowel or bladder dysfunction, or severe bilateral sciatica require emergent MRI and surgical decompression to optimize neurologic recovery.
• Chronic Subdural Hematoma - Adult Management

  Common in elderly and anticoagulated patients; burr hole drainage is standard for symptomatic collections with careful postoperative management to reduce recurrence.

D

• Depressed Skull Fracture - Management

  Open or significantly depressed skull fractures often require operative elevation and debridement with antibiotic prophylaxis and tetanus update.

E

• Epidural Hematoma - Trauma Emergency Management

  Lens shaped hematoma from arterial bleeding with risk of rapid decline. Urgent neurosurgical evacuation with airway and blood pressure control.
• External Ventricular Drain - Placement and Care

  CSF diversion for hydrocephalus or intracranial pressure monitoring; maintain sterile technique, correct leveling, and strict CSF handling protocols to reduce infection and malfunction.

I

• Intracerebral Hemorrhage - Surgical Indications

  Identify patients for surgery such as cerebellar hemorrhage with neurologic decline or hydrocephalus, lobar hemorrhage with mass effect in select cases, and refractory intraventricular obstruction.
• Intracranial Vasospasm After SAH - Management

  Prevent with nimodipine and euvolemia; monitor clinically and with TCD or CTA, and treat symptomatic vasospasm with blood pressure augmentation and endovascular therapy.

M

• Malignant MCA Infarction - Decompressive Hemicraniectomy

  For large hemispheric infarction with swelling, early decompressive hemicraniectomy reduces mortality and improves survival in selected patients.

N

• Neurogenic Shock After SCI - Vasopressors

  Loss of sympathetic tone causes hypotension and bradycardia; treat with fluids and vasopressors targeting MAP goals, using norepinephrine as first line in many centers.
• Normal Pressure Hydrocephalus - Evaluation and Shunt

  Evaluate gait disturbance, cognitive decline, and urinary symptoms with imaging and CSF drainage trials; ventriculoperitoneal shunt for responders.

P

• Penetrating Brain Injury - Initial Management

  Control hemorrhage and airway, avoid projectile removal in field, give antibiotics for open injuries, obtain CT angiography when vascular injury is suspected, and arrange urgent neurosurgery.
• Pituitary Apoplexy - Acute Management

  Sudden headache, visual loss, and ophthalmoplegia with hypotension; give stress dose steroids, obtain MRI, and consult neurosurgery and endocrinology for decompression and hormone care.
• Pituitary Apoplexy — Acute Headache, Visual Loss, Steroids, and Decompression

  Sudden severe headache with visual loss/ophthalmoplegia due to hemorrhage or infarction of a pituitary adenoma. Give stress‑dose steroids (e.g., hydrocortisone 100 mg IV bolus then 50 mg q6h), obtain urgent MRI and endocrine labs, correct electrolyte and volume derangements, and arrange neurosurgical decompression for visual compromise or neurologic deterioration.
• Posterior Fossa Mass - Acute Deterioration

  Beware rapid herniation and obstructive hydrocephalus; secure airway, treat intracranial pressure, and urgently consult neurosurgery for decompression or CSF diversion.

S

• Spinal Epidural Abscess - Urgent Management

  Back pain with fever or neurologic deficits warrants MRI and early antibiotics; urgent decompression and debridement when neurologic impairment or instability.
• Spinal Epidural Abscess — Recognition & Management

  Back pain with fever and neurologic deficits is a red flag; obtain urgent MRI with contrast; start IV antibiotics and consult neurosurgery early for decompression if deficits or cord compression.

T

• Traumatic Brain Injury - ICP Management

  Head elevation, sedation and analgesia, osmotherapy with hypertonic saline or mannitol, ventilation targets, and timely neurosurgical consultation for refractory intracranial hypertension.
• Traumatic Spinal Cord Injury - Acute Management

  Immobilize spine, maintain MAP goals, avoid routine high dose steroids, and obtain early MRI and decompression for ongoing cord compression.