Types of neurosugery..

Can be divided into two: general: cases for which an operation was predicted before. emergency: head injury accidents..

Procedures to be followed in general surgery

medical history questionnaire: patient is asked about his medical history as in medications he has been taking if any, allergies,age,habits such as smoking..etc.. NOTE:Some medications such as antihypertensive drugs can be continued unless specifically mentioned by the physician.

 Preparation of parts: 1.Shaving of head and genital parts. 2.Do not swallow any water and eat food for specified hours prior to the operation.

3.Remove all ornaments and accessories such as watches,chains,earing etc..

Blood Tests: 1.Test for blood sugar

2.Urea and Electrolytes to know the functioning of kidneys and may influence the choice of anesthesia
3.Full blood count: if anemic it can lead to myocardial infraction,intra-operative hypoxia and delayed healing. also can be used as a baseline measure of hemoglobin if proposed op is expected to have blood-loss. 4.Clotting and platelet function also patients blood group is indentified so that is becomes easier to arrange for blood in case of heavy blood loss.

 Diagnosis Tests and Imaging results: ECG: This will show any silent myocardial infarction. It is also a baseline to compare against possible post-op events. Spirometry: Spirometry is the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is an important tool used for generating pneumotachographs which are helpful in assessing conditions such as asthma,cyctic fibrosis etc.. X-Ray: Rules out infection and prevents last minute delay in anaesthetic. It is also an aid to diagnosis if the patient has a poor response to general anaesthetic. It may also help plan for post-operative physiotherapy. Also patients with arthirites at lower back (ankylosing spondylitis) can have a semifused spinal column and the anaesthetist should bear this in mind when extending the patient's neck during intubation. CT Scan: reveals bone deformities, narrowing of intervertebral discs and loss of cartilage. Myelogram: X-ray or CT scan of lumbar spine after a special dye has been injected into the spinal fluid

Neurosurgery-Case study 1:
The investigation for the type of tumor involved: The most common radiological investigations are: Computerized tomography (CT or CAT) scan of the head, with and without contrast Magnetic resonance imaging (MRI) of the head, with and without contrast Other special investigations depend on the tumor and may include: PET(Positron Emission Spectroscopy) scanning MR tractography to determine the spatial relationship of tumor eloquent regions such as speech, visual and motor centers MR Spectroscopy to determine the nature of the tumor.. Pl Note: do not perform lumbar puncture it may lead to downward herination-(brain shifts across structures within the skull-may occur as side effect of high intra-cranial pressure). The remaining procedures remain same as in general surgery like blood tests,etc.

Case Study 2:
72-year old man-admitted-accident case. -Cost of disability is very high in this case. -Physical examination and neurologic assessment by a neurosurgeon is very important and a brain CT Scan is very vital -then a catheter is inserted to monitor the intra-cranial pressure -CT Scan was obtained-abnormality prompts in MRI Scan of the brain -Further procedures remain the same.