EDAIC Neuroanesthesia and Neuromonitoring 2

Question 1

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

Accepted Answer

Motor evoked potentials (MEPs)

Answer

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

Question 2

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

Accepted Answer

Total intravenous anesthesia with propofol and remifentanil

Answer

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

Question 3

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

Accepted Answer

Reduction in another intracranial compartment volume

Answer

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.

Question 4

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

Accepted Answer

Sevoflurane

Answer

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

Question 5

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

Accepted Answer

35-40 mmHg

Answer

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

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC Neuroanesthesia and Neuromonitoring 2