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Test Bank For Ablative Therapies in Neurosurgery, An Issue of Neurosurgery Clinics of North America, 1st Edition Editors P

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Chapter 5: Awake Laser Ablation with Continuous Neuropsychological Testing During Treatment of Brain Tumors and Epilepsy 1. What is the primary purpose of awake laser ablation in neurosurgery? A) Diagnostic evaluation B) Tumor removal C) Pain management D) Neuropsychological assessment Answer: B) Tumor removal Rationale: Awake laser ablation is primarily used for the removal of tumors while allowing for monitoring of neurological functions. 2. Which of the following are advantages of awake laser ablation compared to traditional methods? A) Reduced hospital stay B) Increased risk of infection C) Real-time neuropsychological feedback D) Higher cost Answer: A) Reduced hospital stay, C) Real-time neuropsychological feedback Rationale: Awake laser ablation allows for immediate feedback on cognitive functions, which can lead to shorter hospital stays compared to traditional methods. 3. In the context of awake laser ablation, what is the role of continuous neuropsychological testing? A) It helps to identify the tumor type. B) It guides intraoperative decision-making. C) It measures patient anxiety levels. D) It is not relevant during the procedure. Answer: B) It guides intraoperative decision-making. Rationale: Continuous neuropsychological testing during awake laser ablation provides real-time data that helps neurosurgeons make informed decisions during the procedure. 4. Which of the following scenarios would most likely benefit from awake laser ablation? A) A patient with a large benign tumor in the limbic system B) A patient with severe chronic headaches C) A patient with a small tumor in the brainstem D) A patient suffering from mental health disorders Answer: A) A patient with a large benign tumor in the limbic system Rationale: Tumors in functional areas of the brain, such as the limbic system, can be better managed with awake techniques to preserve neurological functions. 5. Select all that apply: What are potential complications of awake laser ablation? A) Hemorrhage B) Neurological deficits C) Permanent loss of cognitive functions D) Enhanced recovery post-surgery Answer: A) Hemorrhage, B) Neurological deficits, C) Permanent loss of cognitive functions Rationale: While awake laser ablation has many benefits, it still carries risks such as bleeding, neurological deficits, and possible cognitive impacts. 6. What type of anesthesia is used during awake laser ablation procedures? A) General anesthesia B) Local anesthesia with sedation C) Regional anesthesia D) No anesthesia Answer: B) Local anesthesia with sedation Rationale: Local anesthesia with sedation allows patients to remain awake and alert during the procedure while minimizing discomfort. 7. Continuous neuropsychological testing can help identify: A) Pre-existing cognitive impairments B) The need for further imaging C) Real-time functional impairment during surgery D) The psychological impact of the surgery Answer: C) Real-time functional impairment during surgery Rationale: Continuous testing provides immediate feedback on the patient's cognitive function, allowing for adjustments to the surgical approach if necessary. 8. Which patient population may be particularly suited for awake laser ablation? A) Elderly patients with cognitive decline B) Comatose patients with brain cancer C) Patients with seizures due to intracranial tumor D) Patients with systemic diseases Answer: C) Patients with seizures due to intracranial tumor Rationale: Patients with seizures can benefit from awake procedures that allow monitoring of neurological status during tumor resection. 9. What is a significant ethical consideration when performing awake laser ablation? A) Ensuring that patients are unaware of the risks B) Obtaining informed consent C) Minimizing surgical costs D) Placing patients in a controlled environment Answer: B) Obtaining informed consent Rationale: It is crucial to ensure that patients are fully aware of the risks and benefits before proceeding with awake surgical techniques. 10.Select all that apply: Which factors may affect the choice of awake laser ablation? A) Tumor location B) Patient's general health C) Age of the patient D) Complexity of the tumor Answer: A) Tumor location, B) Patient's general health, C) Age of the patient, D) Complexity of the tumor Rationale: All these factors can influence the decision-making process when considering awake laser ablation as a treatment option. 11.During awake laser ablation, which of the following might trigger immediate intervention by the surgical team? A) Increase in vital signs B) Changes in patient speech C) Subtle behavioral changes D) Patients requesting sedation Answer: B) Changes in patient speech Rationale: Changes in speech can indicate neurological impairment, prompting immediate attention and potential modification of the surgical approach. 12.What is the main imaging technique used during awake laser ablation to guide the procedure? A) MRI B) CT scan C) X-ray D) Ultrasound Answer: A) MRI Rationale: MRI is often used for its detailed visualization of brain structures, which is essential in guiding awake laser ablation. 13.Select all that apply: What are common indications for using awake laser ablation? A) Malignant brain tumors B) Benign brain tumors C) Epilepsy D) Acoustic neuromas Answer: A) Malignant brain tumors, B) Benign brain tumors, C) Epilepsy Rationale: Awake laser ablation can be indicated for both malignant and benign tumors and is also beneficial for epilepsy management. 14.What is a possible psychological impact on patients undergoing awake laser ablation? A) Increased peace of mind B) Anxiety and stress C) Lesser curiosity about their condition D) Sense of control over treatment Answer: B) Anxiety and stress Rationale: Many patients may experience anxiety and stress due to the awareness of the procedure being performed while they are awake. 15.Which of the following is a key benefit of using laser technology in ablative surgeries? A) Effective in all patients B) Minimal risk of damage to surrounding tissue C) Resulting in higher overall costs D) Longer recovery times Answer: B) Minimal risk of damage to surrounding tissue Rationale: Laser technology provides a precise method to remove tissue, reducing the risk of damage to surrounding healthy structures.

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Test Bank For Ablative Therapies in
Neurosurgery, An Issue of Neurosurgery
Clinics of North America, 1st Edition
Editors :
Peter Nakaji & Oliver Bozinov

, Chapter 1: History of Ablation
Therapies in Neurosurgery
1. What is the primary purpose of ablation therapies in neurosurgery?
A) To enhance neural function
B) To remove or destroy specific areas of brain tissue
C) To increase blood flow to the brain
D) To implant devices in the brain
Answer: B) To remove or destroy specific areas of brain tissue
Rationale: Ablation therapies are designed to target and eliminate pathological brain
tissues, such as tumors or areas causing seizures.
2. Which of the following was one of the earliest forms of ablation therapy used in
neurosurgery?
A) Gamma Knife radiosurgery
B) Stereotactic surgery
C) Electrocoagulation
D) Laser ablation
Answer: C) Electrocoagulation
Rationale: Electrocoagulation was one of the oldest techniques used for tissue
destruction in neurosurgery.
3. Select all that apply: Which of the following conditions have historically been treated
with ablation therapies?
A) Epilepsy
B) Parkinson's disease
C) Neoplasms
D) Traumatic brain injury
Answer: A) Epilepsy, B) Parkinson's disease, C) Neoplasms
Rationale: Ablation therapies have been utilized to treat conditions such as epilepsy,
Parkinson's disease, and tumors, rather than traumatic brain injuries.
4. In the context of neurosurgery, what does the term "stereotactic" refer to?
A) A collection of imaging techniques
B) A method of locating structures in three-dimensional space
C) A type of anesthetic used during procedures
D) A process to enhance recovery post-surgery

, Answer: B) A method of locating structures in three-dimensional space
Rationale: Stereotactic techniques allow precise targeting of brain tissues based on
three-dimensional coordinates.
5. Which technological advancement significantly improved the precision of ablation
therapies in the late 20th century?
A) MRI
B) CT scans
C) Ultrasound
D) X-rays
Answer: A) MRI
Rationale: MRI technology has greatly enhanced the capabilities for imaging and
planning in neurosurgery, allowing for more precise ablation procedures.
6. Practical Scenario: A patient with medication-resistant epilepsy is being considered
for ablation therapy. What key factor would most likely inform the decision to
proceed?
A) Age of the patient
B) Type of seizure disorder
C) Availability of surgical facilities
D) Patient’s family history
Answer: B) Type of seizure disorder
Rationale: The specific type of seizure disorder and the relationship of seizures to
identifiable brain regions are crucial in deciding upon the suitability for ablation
therapy.
7. Select all that apply: Which of the following are potential complications associated
with ablation therapies?
A) Infection
B) Hemorrhage
C) Neurological deficits
D) Spine deformities
Answer: A) Infection, B) Hemorrhage, C) Neurological deficits
Rationale: Complications can include infections, bleeding, and neurological changes,
but spine deformities are not typically related to ablation.
8. In what decade did the use of laser technology for ablation in neurosurgery become
prominent?
A) 1960s
B) 1970s
C) 1980s
D) 1990s

, Answer: C) 1980s
Rationale: The 1980s saw significant advances in laser technology applied to
neurosurgical procedures.
9. Multiple-choice question: What is the primary advantage of using radiofrequency
ablation in neurosurgery?
A) Instant tissue removal
B) Minimal thermal diffusion to surrounding tissues
C) Cheaper than other methods
D) No need for anesthesia
Answer: B) Minimal thermal diffusion to surrounding tissues
Rationale: Radiofrequency ablation allows for targeted heating of tissue, minimizing
damage to adjacent areas.
10. Practical Scenario: A neurosurgeon's decision to use an ablative approach for tumor
resection may depend on:
A) The visible size of the tumor on a scan
B) The tumor's location and involvement with critical structures
C) The age of the surgical team
D) The presence of a second opinion
Answer: B) The tumor's location and involvement with critical structures
Rationale: The decision to proceed with ablation therapy is strongly influenced by the
tumor's relationship to vital neuroanatomical structures.
11. Select all that apply: Which of the following techniques can be utilized for ablation
therapies?
A) Cryoablation
B) Irreversible electroporation
C) Focused ultrasound
D) Microdiscectomy
Answer: A) Cryoablation, B) Irreversible electroporation, C) Focused ultrasound
Rationale: Cryoablation, irreversible electroporation, and focused ultrasound are
techniques used for tissue ablation, while microdiscectomy is a different surgical
approach.
12. Which ablation technique involves the use of cooled probes to destroy tissues?
A) Radiofrequency ablation
B) Laser ablation
C) Cryoablation
D) High-intensity focused ultrasound
Answer: C) Cryoablation
Rationale: Cryoablation uses extreme cold via probes to destroy abnormal tissues.

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