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NEUROLOGY AND OPHTALMOLOGY

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Versione italiana
Academic year
2022/2023
Teacher
MAURA PUGLIATTI
Credits
10
Didactic period
Secondo Semestre

Training objectives

The Integrated Course includes the teachings of:
Neurology
Ophthalmology
Neurosurgery
Neuroradiology
The integrated teaching aims to provide the fundamental knowledge to be able to recognize the main dysfunctions and/or alterations of the central and peripheral nervous system, of the neuromuscular plate, of the muscle, of the visual system for the purpose of an appropriate diagnostic classification also through integrated methods laboratory, instrumental (neuroimages). The student will also have to know the possible complications and prognostic aspects related to neurological pathology as well as the existence of specific diagnostic-therapeutic pathways for patient management in this area.

At the end of the course, students should be able to:
In terms of knowledge:
know the main dysfunctions and/or alterations of the central and peripheral nervous system, of the neuromuscular plate, of the muscle, of the visual system, the relative semeiology and the relative emergency conditions;
know the semiology of trauma, neurosurgical emergencies, the clinic of neurosurgical pathology;
know the neuroradiological anatomy, the indications of the main neuroimaging methods (e.g. use of cerebral CT, brain and cervico-dorsal spine MRI, use of particular scans, use of contrast medium) for diagnostic and prognostic purposes;
where possible, know differences in the expression of the aforementioned clinical conditions by sex and/or gender and age;

In terms of skills:
know how to recognize the above on the patient:
knowing how to perform a standard neurological objective examination to detect dysfunctions on a cognitive level (language, orientation, memory, praxis, recognition), motor (e.g. central paresis and peripheral motion paresis), sensory (sensory pathways) tactile, thermo-pain, proprioceptive, neuropathic pain and nociceptive pain), cerebellar, neuromuscular, muscular;
knowing how to set up efficient and effective diagnostics (e.g., included in existing diagnostic-therapeutic care pathways if any);
know how to set up a level I therapy or know the complications and contraindications of therapies in neurological pathology (e.g. muscle relaxants in myasthenia gravis).

Prerequisites

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Modulo: 006150 - NEUROLOGIA
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Basic knowledge of the anatomy, physiology and pathology of the central and peripheral nervous systems, the neuromuscular plate and the muscle

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Modulo: 006991/2 - NEUROCHIRURGIA
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Basic knowledge of anatomy, physiology, and pathology of the nervous system

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Modulo: 47586 - NEURORADIOLOGIA
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Basic knowledge of the anatomy, physiology and pathology of the central and peripheral nervous system

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Modulo: 47952 - MALATTIE APPARATO VISIVO
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Knowledge of physics, biochemistry, anatomy, physiology, general pathology, pharmacology, pathological anatomy, endocrinology, immunology.

Course programme

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Modulo: 006150 - NEUROLOGIA
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Motor function, Sensory functions, Higher cortical functions (speech, apraxia, agnosia, disturbances in spatial exploration and body schema, intellectual or mental functions)
Psychoorganic syndromes
Function of cranial nerves and spinal nerves
Acute and chronic pain
Lumbar puncture, CSF analysis
Medullary syndromes, Bulbar, pontine, midbrain syndromes, Cerebellar syndrome, Cerebral cortical syndromes, Thalamic syndromes, Hypothalamic syndromes, Altered intracranial pressure syndromes
Altered consciousness and coma. Neurovegetative syndromes
Inflammatory diseases
Vascular diseases
Dementias
Diseases of the extrapyramidal system
Demyelinating diseases
Epilepsies and occasional seizures
Syncopations
Headaches and neuralgias of the head and face
Motor neuron diseases
Hereditary spastic paraparesis and ataxias
Toxic diseases and from physical agents.
Deficiency diseases
Peripheral nerve diseases
Muscle diseases
Myasthenia gravis and myasthenic syndromes
Congenital diseases.
Genetic metabolic diseases
Diseases of the vegetative nervous system or dysautonomies
Sleep and its alterations
Neurological complications of internal medicine diseases
Coma, Encephalitis and meningitis. Acute disturbances of vision. Acute polyradiculoneuritis. Myasthenic crises and cholinergic crises. Status epilepticus.
Gender Neurology.
Principles of Electrophysiology: Electroneurography, electromyography, electroencephalography, multimodal evoked potentials.

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Modulo: 006991/2 - NEUROCHIRURGIA
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CSF dynamics alterations: hydrocephalus, benign intracranial hypertension
Intracranial hypertension and intracranial hypotension: Changes in intracranial pressure.
Treatment of intracranial hypertension and CSF fistula.
Cranial-brain trauma: GCS. Fracture. Post-traumatic parenchymal lesions.
Extradural hematoma. Subdural hematoma. Intraparenchymal hematoma.
Notes on neoplastic pathology: Primary brain tumors. Tumors in childhood. Skull tumors. Metastasis. Pituitary adenomas
Vascular Pathology: Subarachnoid Hemorrhage and Aneurysms. Subarachnoid hemorrhage and vascular malformations.
Spinal Pathology: Degenerative Pathology (disc herniation; vertebral stenosis). Traumatic pathology. ASIA score. Conus/cauda syndrome

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Modulo: 47586 - NEURORADIOLOGIA
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Neuroradiological semiotics of the Central and Peripheral Nervous System, spine
Indications for the use of different diagnostic methods (CT, MRI, angiography)
Inflammatory pathology
Cranial-brain trauma
Tumor pathology
Vascular Pathology: Subarachnoid Hemorrhage and Aneurysms. Subarachnoid haemorrhage and vascular malformations, acute ischemic stroke, endovascular diagnosis and treatment.
Spinal Pathology: Degenerative Pathology (disc herniation; vertebral stenosis). Traumatic pathology.

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Modulo: 47952 - MALATTIE APPARATO VISIVO
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Embryology, anatomy and physiology of the eye.
Diseases of the eyelids and adnexa. Diseases of the eyeball. Diseases of the orbit.
Neuro-ophthalmology. Diseases of the visual apparatus in relation to general diseases.
Traumatology of the orbit and eyeball.
Prevention in ophthalmology. Pediatric ophthalmology.
Pathophysiological optics (physiology of vision, binocular vision, refractive errors, strabismus).

Didactic methods

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Modulo: 006150 - NEUROLOGIA
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Neurology
Frontal lesson. Exercises in the ward, in day hospitals, outpatient clinics, laboratories of neurophysiology and neurochemistry. Observation of surgeries.
Participation in seminars, specialization courses, conferences related to neuroscience applied to the clinic.

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Modulo: 006991/2 - NEUROCHIRURGIA
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Frontal lesson. Exercises in the Operating Theater and in the outpatient clinics.

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Modulo: 47586 - NEURORADIOLOGIA
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Frontal lesson. Participation in the execution and reporting of neuroradiological examinations. Observation of cerebrovascular interventional and percutaneous spinal interventional procedures.

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Modulo: 47952 - MALATTIE APPARATO VISIVO
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Frontal lesson. Exercises in the Operating Theater and in the outpatient clinics

Learning assessment procedures

The achievement of the learning outcomes will be verified by means of a written exam consisting of 33 questions and lasting 40 minutes. The questions will be formulated with multiple choice questions (5 options for each question) and related to all the training objectives as defined above.
The questions will be prepared in order to verify the knowledge acquired by the student about Neurology (16 questions), Neurosurgery (4 questions), Visual apparatus disorders (10 questions) and Neuroradiology (3 questions).
Each correct answer will be evaluated 1.0 point and there will be no penalty for incorrect or not given answers. The exam mark is assigned in a scale out of thirty: 18/30 is the minimum for passing the exam, achieved by correctly answering to 18 questions out of 33, while the maximum mark, 30 cum laude, will be attributed to those who pass the score of 30.

Reference texts

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Modulo: 006150 - NEUROLOGIA
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Didactic material provided by the teacher.
Texts:
Fazio Loeb. Neurology. 2019. HUS Universe
Berardelli A. The Neurology of Sapienza. Aesculapius Publishing Company. Ed. 2022

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Modulo: 006991/2 - NEUROCHIRURGIA
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Mark S. Greenberg, Handbook of Neurosurgery, 9th Edition, Thieme, December 2019

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Modulo: 47586 - NEURORADIOLOGIA
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Manuale di Neuroradiologia di Andreula - Cirillo - Gallucci - Scarabino 2016
Neuroradiologia di Cesare Colosimo 2013

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Modulo: 47952 - MALATTIE APPARATO VISIVO
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Ophthalmology
Ophthalmology lecture notes (available on the website)
Kanski's Clinical Ophtalmology, A Systematic Approach, Elsevier, 8th edition 2015