This book reviews the common clinical scenarios that might trigger emergent consultation for neurosurgical intervention, with attention to key components of the clinical interview and exam, optimal diagnostic evaluation, indications for and the goals of operative intervention, perioperative considerations, and strategies for complication mitigation. This is not a surgical atlas, but rather, a road map for the journey to the operating room door. The intent is to establish a systematic, evidence-based action plan for the patient presenting in neurologic crisis.
Each chapter opens with a relevant case vignette and then unfolds through uniform sections to tell the story of how one might approach the disease entity in question, from initial request for consultation to definitive management, highlighting steps of the decision-making process. Each chapter is punctuated by 3-5 teaching pearls, summarizing these key elements. The overall goal is to create a framework for assessment that might be applied in the emergency department, the trauma bay, or the ICU when a neurologic emergency arises.
The scope encompasses not only cranial and spinal trauma, but also entities such as shunt failure, stroke, aneurysmal subarachnoid hemorrhage, pituitary apoplexy, cauda equina syndrome, and central nervous system infection that might require time-sensitive intervention. An additional section addresses issues requiring emergent neurosurgical response in the ICU setting, including sudden neurologic worsening, status epilepticus, and abnormal clotting/ coagulopathy.
• Chapters open with a relevant case vignette and includes 3-5 teaching pearls
• Reviews common clinical scenarios that might trigger emergent consultation for neurosurgical intervention
• Establishes a systematic, evidence-based action plan for the patient presenting in neurologic crisis