Indian Journal of Neurotrauma 2015; 12(01): Q1-Q3
DOI: 10.1055/s-0035-1555666
Neurotrauma Quiz
Neurotrauma Society of India

Neurotrauma Quiz – June 2015

Anand Sharma
,
Arif Hameed Shah
,
Yashbir Dewan
Further Information

Publication History

Publication Date:
30 June 2015 (online)

  • Q1. Which of the following is not an inclusion criterion for patient selection in RESCUE – ICP trial?

    • Requiring ICP monitoring with raised ICP (>25 mmHg >1–12 h), refractory to initial medical measures

    • Patient may have an immediate operation for amass lesion but not a decompressive craniectomy

    • Abnormal CT scan

    • A devastating injury not expected to survive for 24 h

  • Q2. Which of the following is not correct regarding modified marshal grading?

    • Grade 1: diffuse injury with no visible pathology

    • Grade 3: diffuse injury and brain swelling

    • Grade 4: diffuse injury and midline shift >5 mm

    • Grade 5: diffuse injury with non-evacuated mass lesion (EDH, SDH, ICH > 25cc)

  • Q3. Which of the following is not true regarding surgical steps used following decompressive craniectomy in RESCUE – ICP trial?

    • Wide decompressive craniectomy (>15 cm in diameter)

    • Opening the dura and leaving it open

    • Documenting the size of the created bony window in the data collection proforma

    • Avoiding tight bandage or positioning patient head on craniotomy side, after decompression

  • Q4. Which of the following is not an inclusion criterion for patient selection in STICH (Trauma) trial?

    • Patient should be present within 72 h of injury

    • Traumatic ICH more than 10 cc on CT scan

    • No associate significant surface hematoma (EDH, SDH)

    • Treating neurosurgeon should be in equipoise

  • Q5. What is not true about STICH (Trauma) trial?

    • Primary objective is to determine whether a policy of early surgery in patients with traumatic intracerebral hemorrhage improves outcome compared to a policy of initial conservative treatment

    • Another objective is to confirm appropriate thresholds for intracranial pressure (ICP) and cerebral perfusion pressure (CPP) for clinical management of head injured patients with TICH

    • 840 patients recruited between October 2009 and March 2013

    • Outcome will be measure at 3, 6, 9, 12 months via a postal questionnaire using extended Glasgow Outcome Scale

  • Q6. DECRA trial was criticized on the following aspects except?

    • 27% of patients randomized to surgery had bilateral nonreactive pupils, compared to only 12% of patients in medical group

    • The DECRA trial contains no data or valuable information to inform modern management of TBI and thus should be ignored by practitioners treatment options for severe TBI

    • The medical and surgical teams were aware of study-group assignments but assessors were not

    • The median ICP during the 12 h before randomization was 20 mmHg

  • Q7. RESCUE-ICP trial differs from DECRA trial on the following aspects except?

    • ICP threshold were 25 mmHg vs. 20 mmHg

    • Duration of refractory raised ICP (>1 h vs. 15 min)

    • Acceptance of contusions

    • Shorter follow vs. longer follow up

  • Q8. All is true about the evidence-based medicine, except?

    • Class 1: Systemic reviews of prospective randomized controlled trials

    • Class 2: Observational studies

    • Class 3: Case control studies

    • Technology assessment includes device accuracy and reliability

  • Q9. Which of the following is not true about CRASH 3 trial?

    • Aim of study were to provide reliable evidence about the effect of tranexamic acid (TXA) on mortality, disability, risk of vascular occlusive events in patients with TBI

    • To be included in study patients should be admitted within 8 h of injury with intracranial bleeding on CT scan and GCS should be10 or below

    • Treatment consistent of 1 g loading dose of TXA followed by maintenance 1 g dose over 8 h

    • Patient recruitmentwas takenplace inover 30 countries,was started on April 2012 and will be end on 31 December 2016

  • Q10. Indian institution has participated in the following trials except?

    • STICH Trial

    • RESCUE-ICP Trial

    • CRASH Trial

    • CRASH 3 Trial

  • Q11. According to the CRASH trial, which of the following statements about outcome at 6 months among patients hospitalized with TBI who received 1 g methylprednisolone vs. placebo care is not correct?

    • Risk of death were higher in corticosteroid group than placebo

    • Risk of death were higher in placebo group than corticosteroid group

    • Risk of severe disability were higher in corticosteroid group than placebo

    • There was no clear evidence that the relative risk of death or disability at 6 months differed substantially between groups when stratified by injury severity or time since injury

  • Q12. Which of the following is not true about neural-stem trial for chronic spinal cord injury?

    • First FDA approved trial

    • It requires transplantation of stem cell in white matter of patient's spinal cord

    • Stem cells works with replacing damaged cells, neuroprotection or the creation of an environment conducive to regeneration by endogenous cells

    • Total 4 patients recruited

  • Q13. What is true about The Neurotrauma Society of India except?

    • First established as Neurotraumatology Committee under NSI in 1992

    • Neurotrauma Society was officially announced on 18th August 1999

    • The Logo depicts head and the spine and prepared in 1992

    • First issue of The Indian Journal of Neurotrauma was published in 2004

  • Q14. Mild traumatic brain injury includes all except

    • Any period of loss of consciousness for up to 15 min

    • Any loss of memory for events immediately before or after the accident for as much as 24 h

    • Any alteration of mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused)

    • Focal neurological deficit(s) that may or may not be transient

  • Q15. According to brain trauma foundation, which of the following statement is incorrect regarding the use of steroid in severe traumatic brain injury?

    • Level 1 evidence which do not support use of steroids in moderate to severe TBI

    • High dose methylprednisolone is associated with increased mortality secondary to increased risk of infection and gastrointestinal bleeding and is contraindicated

    • Steroids were introduced in early 1960s as a treatment for brain edema

    • Glucocorticoid within 24 h associated with 74% increased risk of first late seizure