With a 241, you have a strong shot anywhere, regardless of your grades. If you have research experience and strong recs/neurosurgery director support, you will get plenty of interviews. Strong overall grades and AOA help a little, but they're not as important as Step I scores, recs, political support, prestige of school attended, research, social aptitude, etc. However, your grades in your Neurosurgery/Surgical rotations are extremely important. If you don't honor them, it'll raise some questions. Plus, it'll hurt your ability to get full support of your program director (who you need to not only write you a recommendation, but to take time to make phone calls post-interview/pre-match and to his friends at other programs). If you just high pass, etc., you'll likely still be fine, but work your butt off to impress both at your school's neurosurgery program and at your subIs.
In terms of taking the Step II, it's not required prior to the match and programs won't hold it against you in interviews, so I don't know if it's worth the risk. Usually, people take Step IIs earlier to offset a bad Step I. You proved yourself, so unless you are a FMG (where you need to do whatever you can to offset FMG-status), I don't think it's necessary. But you should ask for second opinions on that one, since it's a judgment call.
