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Medicine

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Neurology

Question
10 out of 21
 

Most common nerve involved in intracranial aneurysm is : (DNB Dec 2010)



A Trochlear
B VII

C VIII
D Oculomotor

Ans. D

Oculomotor

Investigations –

1). C.T head (Best to diagnosis). Non contrast CT scan: Investigation of choice (LP is not indicated prior to an imaging procedure). Blood is seen in the sylvian fissure.

2). CSF examination:

a. Hallmark is blood in CSF

b. Xanthochromic CSF – lysis of RBCS and Subsequent conversion of Hb to bilirubin stains the spinal fluid yellow within 6 – 12 hours. Peak 48 hours & lasts for 1 – 4 weeks.

3). MR angiography – For unruptured aneurysm.

Treatment –

1). Medical support

a. Airway protection

b. BP management

c. Prevent vasospasm – Nimodipine, volume expansion.

2). Triple H method of Rx Hypertension, hemodilution & hypervolemia (Ref. Hari-18th ed., pg- 2264)

3). If vasospasm persists

a. Intracranial papaverine

b. Phenytoin given as prophylactic therapy

c. Surgery – Clipping of aneurysm

4). Recent Advances = Endovascular coiling

Neurology Flashcard List

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