Neurosurgical Consult Book, The

Right Arm Swelling After Surgery

Consult Page 30F with recent spine surgery, here with right arm swelling Initial Imaging None Walking Thoughts ■ What surgery did she have? How long ago was her surgery? ■ What was her postoperative course? When and where did she…

Right Facial Pain

Consult Page 51F with 3d unremitting right facial pain Initial Imaging None Walking Thoughts ■ What are the characteristics and distribution of the facial pain? Is it shooting and electric-like? ■ Has the patient had any prior episodes of this…

Abnormal Eye Movement

Consult Page 5Y female presenting with eye movement abnormalities. MRI with Chiari malformation. Initial Imaging Walking Thoughts ■ What type of eye movement abnormality does she have? Does she have any other symptoms (e.g. headache, paresthesias, weakness)? ■ Does the…

Baclofen Pump Infection Due To Wound Breakdown

Consult Page 54F with wound breakdown at the abdominal site of her intrathecal baclofen pump Initial Imaging None Walking Thoughts ■ What are the patient’s vital signs? Is she hemodynamically stable? ■ What is the patient’s neurological exam? ■ Is…

Increased Spasticity And Beeping Baclofen Pump

Consult Page 18Y M presents with baclofen pump beeping Initial Imaging Walking Thoughts ■ What are the patient’s vital signs? ■ Is he hemodynamically stable? ■ What is the patient’s neurological exam? ■ Why does the patient have a baclofen…

Abdominal Pain And Fevers in A Shunted Patient

Consult Page 48F here with abdominal pain, low grade fevers. CT abdomen shows multiple abscesses Initial Imaging Walking Thoughts ■ What is the patient’s neurological exam and current vitals? ■ Does the patient have any neurological symptoms? Is she exhibiting…

Falls, Memory Loss, And Fevers

Consult Page 57F here with fevers and history of falls and memory loss. Head CT shows hydrocephalus. Safety of LP? Initial Imaging Walking Thoughts ■ What is the patient’s current neurological exam? ■ What are the patient’s vitals? ■ Is…

Headache, Confusion, And Chronic Rhinorrhea

Consult Page 14F with chronic sinusitis, prior meningitis pw headache, confusion, leakage from nose. Head CT unrevealing. Imaging recs? Initial Imaging Walking Thoughts ▪ What is the patient’s current neurological exam? ▪ What are her current vitals? ▪ What symptoms…

Worsening Vision In Pseudotumor Cerebri

Consult Page 37F h/o pseudotumor with worsening vision, consult for shunt placement Initial Imaging Walking Thoughts ■ What is the patient’s neurological exam? ■ What is the patient’s vision now and how quickly did it deteriorate? ■ Was the patient…