Final exam

Neurosurgery
Professor Badri Saghirashvili
Version 3
30 Questions (multiple choice) 1 point for each, 2 open Questions – 5 points for each.

1) Most common early symptoms for Vestibular schwannomas are all of them, except
a) Hearing loss;
b) Tinnitus (high pitched)
c) Dysequilibrium;
d) Diplopia.

2) Surgical approaches for vestibular schwannomas are all of them, axcept

a) Middle fossa approaches;
b) retrosigmoid approaches;
c) pterional approaches;
d)  translabyrinthine approaches.

3) Oligodendrogliomas frequently presents with

a) Headache;
b) Seizures;
c) Mental status changes;
d) Vertigo/ nausea

4) Signs of Radiculopathy are all of them, except:

a) Pain radiating down LE;
b) Motor weakness;

c) Reflex changes;
d) only Low back pain.

5) Surgical indications for Lumber disc include all of them, except

a) Cauda equna syndrome;

b) Progressive symptoms of neurologic defirits;

c) Local pain of Lumber;
d) seves radicular pain > ≈ 6 weeks.

1
6) L5-S1 herniated lumbar disc usually causes.
a) L5 radiculopathy;

b) L4 radiculopathy;
c) S1 radiculopathy
d) S2 radiculopathy

7) How many nerve roots and vertebrae are in the cervical region?
a) 7 nerve roots and 7 vertebrae;

b) 8 nerve roots and 7 vertebrae;

c) 7 nerve roots and 8 vertebrae;
d) 8 nerve roots and 8 vertebrae.

8) Which nerve roots radiculopathy occasionally presents with pain simulating myocardial
infarction (pseudo-angina)?
a) Left C7 radiculopathy;
b) Left C8 radiculopathy;
c) Right C6 radiculopathy;
d) Left C6 radiculopathy.

9) C6-C7 herniated cervical disc usually causes radiculopathy of

a) C5 root; b) C6 root; c) C7 root; d) C8 root.

10). Diastatic fractures are more common in:

a) Adults; b) Young children; c) Infants; d) Old people.

11) Indication for surgery of depressed skull fracture

a) Depressed < thickness of calvaria
b) Depressed > thickness of calvaria
c) Depression is < 1cm;
d) Depression is > 1cm.

12) Periorbital ecchymoses (raccoon’s eyes) are signs of

a) Posterior fossa fracture
b) Middle fossa fracture;
c) Anterior fossa fracture;

2
d) fracture of Processus mastoideus.

13) Most common source of Epidural hematoma

a) Middle meningeal Vien;
b) Middle meningeal artery;
c) Middle cerebral artery;
d) Middle cerebral Vien.

14) In most caces Epidural hematoma is

a) Spontanais ;
b) Traumatic;
c) Genetic;
d) Inherent.

15) Lucid interval is characteristic for

a) Intracerebral hematoma;

b) Subdural hematoma;
c) Epidural hematoma;
d) Intracerebellar hematoma.

16) Most common sites for intrecerebral hematoma

a) Striate body;
b) Brain stem;
c) Cerebellum;
d) thalamus.

17) Vestibular schwannowas are benign tumor of cranial nerve

a) VII;
b) VIII;
c) V;
d) VI.

3
18) Most common location for Oligodendrogliomas
a) Frontal lobe;
b) Parietal lobe;
c) Occipital lobe;
d) Temporal lobe.

19) Calcifications are common for;

a) Astrocytomas;
b) Oligodentrogliomas;
c) Meningiomas;
d) vestibular schwannomas.

20) Most common primary intra-axial brain tumors are

a) Oligodendrogliomas;
b) Meningiomas;
c) Astrocytomas;
d) vestibular schwannomas;

21) Which is Non-infiltrative astrocytoma

a) Juvenile pilocytic astrocytoma;
b) Anaplastic astrocytoma;
c)Anaplastic oligoastocyroma;
d) Glioblastoma multiforme.

22) Malignant astrocytoma (WHO(World Health Organization) grade IV) classified as:
a) Pilocytic astrocytoma;
b) Pilomixoid astrocytoma;
c) Pleomorphic xanthoastcytoma;
d) Glioblastoma multiforme.

23) Source of putaminal hemorrhages

a) Microaneurysms of charcot-Bouchers arteries;
b) Middle meningeal artery;

4
c) Microaneurysms of charcot – Bouchards viens
d) Middle cerebral artery aneurysm

24) Wich malignant tumor is most commonly associatet with ICH (intracranial
hemorrhage)?
a) Glioblastoma;
b) Lymphoma;
C) Metastatic Tumor;
d) Meningioma.

25) Most common primary intracranial extra-axial tumors are:

a) Astrocytomas;
b) Oligodendrogliomas;
c) Meningiomas;
d) Vestibular schwannomas

26) Blood accumulation between below the inner layer of the dura but external to the
brain and arachnoid membrane is classified as
a) Epidural hematoma;

b) Subdural hematoma
c) Intraventricular hematoma;
d) Intracerebral hematoma.

27) Time frame of acute subdural hematoma

a) 1 to 3 days;

b) 4 days to 2 or weeks;
c) > 3 weeks and < 3-4 months;
d) After about 1-2 months.

28) ASDH must be evacuated

a) ASAP ( as soon as possible);
b) After 4 hour;
c) After acute period;
d) Only in chromic period.

5
29) Meningiomas arises from
a) Dura mater;
b) Pia mater;
c) Arachnoid membrane;
d) Glial cells.

30) Most common location of meningiomas:

a) Convexity;
b) Parasagittal;
c) Falx;
d) Olfactory groove.

1) Meningiomas etiology, diagnosis, treatment (5points)

2) Pituitary adenoma etiology, diagnosis, treatment (5points)