Indian Journal of Neurotrauma, Table of Contents Indian Journal of Neurotrauma 2015; 12(01): Q1-Q3DOI: 10.1055/s-0035-1555666 Neurotrauma Quiz Neurotrauma Society of India Neurotrauma Quiz – June 2015 Anand Sharma , Arif Hameed Shah , Yashbir Dewan Recommend Article Abstract Full Text PDF Download 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
