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Neuroanesthesia and Neuromonitoring Flashcards

7 cards from real EDAIC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which intraoperative neuromonitoring modality is most sensitive for detecting ischemia in the motor cortex during carotid endarterectomy?

    Answer: Motor evoked potentials (MEPs)

    MEPs directly assess the corticospinal tract and are more sensitive than SSEPs for detecting motor cortex ischemia.

  2. During awake craniotomy for eloquent cortex tumor resection, which anesthetic technique is most appropriate for the 'asleep-awake-asleep' approach?

    Answer: Total intravenous anesthesia with propofol and remifentanil

    TIVA with propofol and remifentanil allows rapid titration and offset, facilitating reliable transitions between sedated and awake states.

  3. The Monro-Kellie doctrine states that a rise in volume of one intracranial compartment must be compensated by:

    Answer: Reduction in another intracranial compartment volume

    The skull is a rigid container, so an increase in any compartment (brain, blood, CSF) must be offset by a decrease in another to maintain constant ICP.

  4. Which volatile anesthetic agent is LEAST likely to increase cerebral blood volume and ICP at 1 MAC?

    Answer: Sevoflurane

    Sevoflurane causes less cerebral vasodilation and ICP elevation than other volatile agents at equivalent doses, making it preferable in neurosurgery.

  5. In a patient with traumatic brain injury, which PaCO2 target is recommended during initial resuscitation to avoid secondary injury?

    Answer: 35-40 mmHg

    Normocapnia (PaCO2 35-40 mmHg) is recommended; prophylactic hyperventilation reduces cerebral blood flow and can cause ischemia.

  6. Cerebral autoregulation maintains constant cerebral blood flow across which range of mean arterial pressure in a healthy adult?

    Answer: 50-150 mmHg

    Cerebral autoregulation is intact between approximately 50-150 mmHg MAP in normotensive adults; outside this range, CBF becomes pressure-passive.

  7. Which drug is the preferred agent for inducing deliberate hypotension during intracranial aneurysm clipping to reduce transmural pressure?

    Answer: Adenosine

    Adenosine-induced transient cardiac arrest or profound bradycardia provides brief profound hypotension for complex aneurysm clipping with rapid recovery.