Neurosurgical Consult Book, The

Progressive Neurocognitive Decline

Consult Page 27F bilateral jaw dislocation. CT with large bifrontal lesion Initial Imaging Walking Thoughts ■ What is the patient’s neurological exam? ■ What other symptoms does the patient have? ■ What is the timeline of her symptoms? ■ Does…

Headache, Blurry Vision, And Intraventricular Mass

Consult Page 20F with headache and dizziness with hydro on OSH CT. MRI pending. Initial Imaging Pending Walking Thoughts ■ What is the patient’s neurological exam? Does she have decreased mental status that requires an emergent intervention (e.g. external ventricular…

Sudden Headache And Vision Loss

Consult Page 45M, Headache, vomiting, sudden vision loss and suprasellar mass Initial Imaging Walking Thoughts ■ What is the patient’s neurological exam? ■ What are the patient’s vitals? ■ Does the patient have a known pituitary adenoma or suprasellar mass?…

Incidental Sellar Mass After An Accident

Consult Page 23F Headache after MVC. MRI with sellar mass Initial Imaging Walking Thoughts ■ What are the patient’s vitals? ■ What is her neurological exam? ■ Does she have any other injuries from the motor vehicle accident? ■ Is…

Altered Mental Status With Brain Lesions

Consult Page 53F, history of IVDU, found unresponsive, HCT with multiple brain lesions, large vents. Initial Imaging Walking Thoughts ■ What is the patient’s current Glasgow Coma Scale (GCS) score? Is the patient protecting her airway? ■ What is the…

New Onset Seizure With Prior History Of Melanoma

Consult Page 64M with history of melanoma presents with a seizure. Head CT concerning for mass/swelling Initial Imaging Walking Thoughts ■ What is the patient’s current neurological exam and mental status? ■ What is the semiology of his seizure? Is…

Headache And Right Arm Weakness

Consult Page 70M new mass on CT Initial Imaging Walking Thoughts ■ What is the patient’s neurological exam? Does he have decreased mental status or any associated neurological deficits? ■ How long has the patient had symptoms, and have the…

Episodes of Foul Smell and Bad Taste

Consult Page 25M transfer from outside hospital with brain mass. MRI pending. Initial Imaging None Walking Thoughts ■ What are the patient’s symptoms and presentation? ■ What medical comorbidities does the patient have? ■ What is the GCS of the…

Headache, Nausea, And Speech Difficulty

Consult Page 51 F p/w headache, nausea, and speech difficulty, MRI large mass. Initial Imaging Walking Thoughts ■ What is the patient’s mental status and neurological exam? ■ Are the neurological findings due to the mass effect or are they…