Assumptions
Students understand basic central and peripheral neurological anatomy and function, including: cross sectional anatomy, histology, gross anatomy, and sensory/motor endpoints.
Objectives
1. Describe the physiology of intracerebral pressure (ICP) and cerebral perfusion pressure (CPP), including the effects of blood pressure, ventilatory status, and fluid balance on ICP and CPP.
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Recognize the Cushing reflex and its clinical importance (brain herniation).
2. Discuss the diagnosis and management of the patient with headaches.
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Describe the signs, etiology and treatment of intracranial hemorrhage (subarachnoid hemorrhage and intracerebral hemorrhage).
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Describe the relative incidence and location of the most common brain tumors, their clinical manifestations, their diagnosis, and general treatment strategies.
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Differentiate brain abscesses from tumors, and discuss the treatment of intracranial infections.
3. Describe the evaluation and management of a patient with an acute focal neurologic deficit.
4. Differentiate TIA, RIND, and CVA.
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Differentiate anterior vs. posterior circulation symptoms.
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Outline the diagnostic tests and monitoring of carotid occlusive disease, including role of angiography and noninvasive methods.
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Discuss medical vs. surgical management of carotid artery disease.
5. Describe the signs, symptoms, and treatment of common peripheral nerve entrapment syndromes, as well as other nerve injuries.
6. Describe the presentation and management of hydrocephalus.
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Compare and contrast adult and pediatric hydrocephalus.
7. Discuss the role of surgery in the management of pain, movement, and seizure disorders.
Problems
1. A 60-year-old patient presents with transient monocular blindness.
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How will you evaluate this patient's neurologic status?
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Describe the importance of a fundoscopic exam.
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Develop a differential diagnosis, evaluation and treatment plan.
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What are the risks of carotid endarterectomy?
2. A 38-year-old arrives in your office complaining of a severe headache.
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What historical and physical findings are important?
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When would you order a CT scan?
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When to obtain a neurosurgical consult (emergent or "routine")?
3. A 45-year-old arrives in your office with complaints of numbness, tingling, and weakness in the
(dominant) right hand.
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How would you proceed with your history, physical examination, and diagnostic evaluation?
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What lesions are possible? How do you differentiate and treat them?

Prevention
1. Students will understand the importance of blood pressure control in the prevention of stroke.
2. Students will understand the importance of early diagnosis and treatment in subarachnoid hemorrhage.
3. Students will understand the importance of appropriate diagnosis, management, referral in the prevention of complications of carotid occlusive disease.