Electrocorticography and Functional Mapping for CLTM Board actual exam questions and answers

Functional mapping with direct cortical stimulation should always be done with concurrent electrocorticography: True or False? True Structural functional anatomy may be altered by: (select all that apply) a. Pressure b. Plasticity c. Current d. Previous lesions a. Pressure b. Plasticity c. Current d. Previous lesions Phase reversal SEP recordings not only identify the central sulcus but also provide information about the distribution of motor function on the adjacent exposed cerebral structures. True or False? False Dr Paul Broca, a neurosurgeon in 1861, identified the area of expressive speech by: a. Studying laboratory animals b. Performing the first EP studies in humans c. Using direct cortical stimulation in surgery d. Following a patient with expressive aphasia and performing an autopsy after the patient's death e. Combining results of CT, MRI, and fMRI d. Following a patient with expressive aphasia and performing an autopsy after the patient's death The growing of new neuronal connections due to new learning opportunities or brain abnormalities or when a normal functioning hemisphere takes over functions of the abnormal side is called: a. Cortical dysplasia b. Mirror focus c. Secondary bilateral synchrony d. Neuroplasticity d. Neuroplasticity Which occluded vessel is most likely to be associated with a stroke? a. Right external carotid b. Right common carotid c. Right middle cerebral artery d. Right posterior communicating artery Right middle cerebral artery An assessment of cognitive function, reasoning, problem solving, expressive language, long and short term memory, attention, processing speed, visual and spacial organization, and visual motor skills is called: a. fMRI b. A neuropsychological evaluation c. SPECT and PET scans d. MRI and CT b. A neuropsychological evaluation Which of the following are part of an Epilepsy Surgery Evaluation? (select all that apply) -Neuropsychology -MRI and CT -Wada Test: Sodium Amobarbital -Video EEG monitoring -Epilepsy conference -EMG and Nerve conduction studies -MEG -SPECT and PET scans -Neuropsychology -MRI and CT -Wada Test: Sodium Amobarbital -Video EEG monitoring -Epilepsy conference -MEG -SPECT and PET scans Which of the following modalities is LEAST useful to monitor during a middle cerebral artery aneurysm? a. Surface EEG b. Cortical EEG c. Upper extremity SSEP d. Brainstem Auditory Evoked Responses (BAER) d. Brainstem Auditory Evoked Responses (BAER) What new imaging techniques help in the placement of ECoG electrodes? a. Ultrasound and standard X-Rays b. Contrast MRI and CT scans c. Digital photographs and MEG d. Fusion of functional SPECT and PET scans and structural MRI d. Fusion of functional SPECT and PET scans and structural MRI How does ECoG activity differ from scalp recorded EEG? (select all that apply) -More sharply contoured morphology -Lower amplitude when recording from the cortex directly -Higher amplitude -Onset decrement or attenuation usually not seen on scalp recordings because it is so low amplitude it is not recorded through the scalp and skull -More sharply contoured morphology -Higher amplitude -Onset decrement or attenuation usually not seen on scalp recordings because it is so low amplitude it is not recorded through the scalp and skull During surgery for an aortic arch dissection, the SSEP's from the lower extremities remain stable, EEG shows no change but there is a gradual loss of the SSEP and Tc-MEP from the left arm. What is the most likely etiology? a. Left side spinal cord injury b. Right cortical injury c. Right brainstem injury d. Occlusion of the left subclavian artery d. Occlusion of the left subclavian artery Which of the following modalities is LEAST useful to monitor during surgery for a vertebral artery aneurysm? a. Lower extremity SSEP b. Brainstem auditory evoked potential c. Surface EEG d. Upper extremity SSEP c. Surface EEG In the past many brainstem lesions were considered inoperable but with modern microsurgical techniques combined with neurophysiological mapping, many lesions in this area are now amenable to surgical intervention. True or False? True How are afterdischarges stopped? a. IV valium b. General anesthesia c. IV antiepileptic drugs d. Irrigation using cold (4 degrees C) Ringer's applied directly to the cortex d. Irrigation using cold (4 degrees C) Ringer's