Neurosurgery Rotations

[peace zealot]

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What major things you people think one must learn during Neurosurgery rotations and how often do you go to the Operation theater during Neurosurgery rotations?

 

[Teee]

you should learn how to do cranial nerve exams including reflexes, muscle strenght and cerebellar function.

For the OR, you will see shunt placements, craniotomies/craniectomies for brain tumors or traumas, and spinal decompression with/without instrumentations. You can also go to the interventional radiology suite for angiograms.

depending on where you are, you might see an aneurysm clipped, although you will most liekly be watching a microscope view, and again depending on where you are, you might see pediatric cases.

 

[soonereng]

What major things you people think one must learn during Neurosurgery rotations and how often do you go to the Operation theater during Neurosurgery rotations?

Well, I went to the OR everyday of the week but one which was resident clinic day.

Know how to do Glasgow Coma Scales for sure for those trauma patients. And know if you operate on X area of the brain, what functions should you test after surgery to assess for deficits. Pretty simple stuff really.

I really enjoyed my NS rotation. Made me think twice about going ENT.

 

[peace zealot]

Thanks for a really good response. I am concentrating on physical exam and its interpretation and learning some CT scans an Angiograms. And just watch a few simple procedures. I revised the basics from High yield at the weekend before I started the rotation. Is there some nice book for Neuro? What other recommendations for study?

 

[illixir]

I just got done with 2 weeks of neurosurgery, we had or everyday except wednesdays(clinic day in afternoon),usually scrubbing in to do some minor things on one case a day and then we came in one of the weekend days for rounds and anything going on. No "theater". I didn't have that much time to do outside studying, days were like 5-5, one or two that went later, a couple shorter.

I felt like most important things were daily presentations on rounds and knowing your patients in and out, thats the main thing we're evaluated on, and some other talk. Knowing all the labs, vitals, acute changes, fluids coming in and out was important esp. for ICU patients and knowing what orders are going in and have gotten done, what needs to get done that day. Actually examining the patients is usually really quick, just check how well their extremities work and how alert they are. Imaging is how the attendings tend to make all their decisions. Try not to present a radiology read if they havent agreed with it, ask the resident what the read is or remember what they say it is if you have radiology rounds prior to patient rounds.

 

[pingouin]

I just finished a week of neurosurg. I was scrubbed into the OR every day but one (afternoon and morning clinic that day). Because I was with someone who focuses on CNS oncology, I saw 4 craniotomies and only 1 diskectomy.

Agree with understanding and being able to perform the neuro exam cold. Know your tumors- supra vs infratentorial and who gets which ones. I was pimped quite a bit on lumbar and cervical root dermatome distribution. I'd also brush up on neuroradiology a little bit, especially your MRI-reading skills. Agree with the suggestion of knowing the GCS well. Oh and know your intracranial bleeds- which vessels are involved in each, most likely cause of the bleed, symptoms, and imaging.

Like illixir, I also didn't have much time to do reading, which was unfortunate. I had to complete 2 patient write-ups that were 4-5 pages each, so between that and being busy all day every day there wasn't much time left to do anything else.

 

[Aphasic]

Like someone said GCS is important, learn how to do a quick and dirty neuro exam, generally no need to test every muscle group, do a full MMSE, or bust out a tuning fork. Also focus on neuroanatomy and reading/describing scans, angios, etc... I would also know things like intracranial hemorrhages (presentation, pathophysiology, appearance on imaging), and most common CNS neoplastic lesions (met vs. primary, kids vs. adults, etc...)

Books (Just my personal recommendations)
Greenberg's Handbook of Neurosurgery
Rhoton's Neurosurgery Explained

Though I wouldn't go buy these unless you're going into nsgy.

Hope this was helpful!