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Module 14 · Anaesthesia Blueprints

Neuroanaesthesia: exam notes and MCQs

Prepare neuroanaesthesia for postgraduate anaesthesia examinations with structured notes, exam-style questions and referenced explanations from standard textbooks and current guidelines.

Practise all 19 Neuroanaesthesia questions free →

Exam notes in this module

Traumatic brain injury and neuroanaesthesia principles
Secondary brain injury, physiological targets, ICP management and venous air embolism.
Spine surgery, prone positioning and neuromonitoring
Evoked potentials, anaesthetic technique, prone position complications and postoperative visual loss.
Craniotomy for supratentorial tumours — principles of neuroanaesthesia
Intracranial compliance, smooth induction and emergence, brain relaxation, fluids, positioning and postoperative care.

Sample questions

Q1. During spine surgery with intra-operative neuromonitoring, which modality is MOST sensitive to suppression by volatile anaesthetics?

  1. Brainstem auditory evoked potentials
  2. Subcortical SSEPs
  3. Cortical SSEPs
  4. Transcranial motor evoked potentials
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Answer D: Transcranial motor evoked potentials

Transcranial MEPs depend on multiple synapses (cortex, anterior horn cell) and are the most sensitive to volatile agents; monitorability degrades non-linearly over a narrow dose range. TIVA (propofol + remifentanil) without neuromuscular blockade is preferred when MEPs are monitored.

Exam style: NEET-SS Anaesthesia

Q2. The MOST sensitive monitor for detecting venous air embolism during sitting craniotomy is:

  1. End-tidal CO₂
  2. Precordial Doppler
  3. Transoesophageal echocardiography
  4. Pulmonary artery pressure
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Answer C: Transoesophageal echocardiography

TOE detects as little as 0.02 mL/kg of air and can also identify paradoxical air crossing a PFO. Precordial Doppler is the most sensitive non-invasive monitor; EtCO₂ falls (and EtN₂ rises) with clinically significant embolism.

Exam style: NEET-SS Anaesthesia

Q3. Normal global cerebral blood flow in an adult is approximately:

  1. 15 mL/100 g/min
  2. 30 mL/100 g/min
  3. 50 mL/100 g/min
  4. 100 mL/100 g/min
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Answer C: 50 mL/100 g/min

Global CBF ≈ 50 mL/100 g/min (≈ 750 mL/min, ~15% of cardiac output) — grey matter ≈ 80 mL/100 g/min, white matter ≈ 20. EEG slowing appears below ≈ 20–25 mL/100 g/min and membrane failure/infarction below ≈ 10–15.

Exam style: NEET-SS Anaesthesia

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