Neurosurgery Syllabus - Australasia

Curriculum - Syllabus Modules
Surgical Education and Training in Neurosurgery

Royal Australasian College of Surgeons & Neurosurgical Society of Australasia
SYLLABUS MODULE – CLINICAL NEUROLOGY
Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes
Clinical examination • Demonstrate an ability to undertake • Demonstrate development of a comprehensive • Clearly demonstrate detailed and specific
a detailed neurological history and differential diagnosis based on focussed clinical findings, such as fourth nerve palsy,
examination. history and examination. internuclear ophthalmoplegia, and
• Present the relevant examination • Altered levels of consciousness functional signs.
findings to colleagues in a clear and • Discuss the anatomical basis and clinical features of
concise manner. persistent vegetative state, akinetic mutism, and the
locked-in syndrome.
• Discuss abnormalities of breathing, pupillary
responses, eye movements, and other signs in
various abnormalities of consciousness.
• Discuss the care of the unconscious patient.
Altered levels of • Discuss the anatomical basis for • Discuss the physiology of sleep.
consciousness consciousness. • Discuss abnormalities of sleep, including
• Discuss the causes of altered levels narcolepsy, cataplexy, and sleep apnoea.
of consciousness.
• Demonstrate a relevant neurological
examination on the unconscious
patient.
• Discuss in detail the diagnosis of
brain death and the methods of
confirming brain death.
• Describe in detail the structure and
application of the Glasgow Coma
Scale.
Epilepsy • Discuss the classification of seizures • Discuss the rationale for epilepsy surgery. • Discuss patient selection for epilepsy
and epilepsy. • Discuss the level of risk of seizure for neurosurgical surgery, including investigations and
• Explain the neurophysiology of disorders and operative interventions. monitoring techniques.
epilepsy. • Describe the rationale for prophylactic anticonvulsant • Describe the different methods of cortical
• Discuss the pharmacology of therapy in various neurosurgical disorders. and depth electrode recording for pre-
common anticonvulsants. • Describe the normal wave patterns present on an operative and intra-operative cases.
• Describe the formal EEG. • Discuss the issues regarding epilepsy and
recommendations for driving in pregnancy.
Updated January 2014

Copyright © Neurosurgical Society of Australasia
patients suffering seizures. • Describe the different types of epilepsy

• Describe the physiological basis for and the underlying neurophysiology,
the EEG. clinical features, and EEG findings for
each.
• Discuss the use of intra-operative
somatosensory evoked potentials, motor
evoked potentials, and intra-operative
electrophysiological localisation in
neurosurgery.
Headache • Discuss the differential diagnosis of • Discuss the theories of pathophysiology of migraine.
headache. • Discuss the general principles of pharmacological
• Describe the clinical features of treatment of migraine.
migraine and the differentiating • Discuss common headaches such as muscle
features from other common types contraction headaches and occipital neuralgia.
of headache. •
• Differentiate the features of benign
headache from those of significant
intracranial pathology.
Demyelination • Describe the pathophysiology, epidemiology and • Explain the diagnostic neurophysiological
clinical features of multiple sclerosis and other forms findings in multiple sclerosis, including
of demyelination. visual evoked potentials.
• Describe the imaging findings in multiple sclerosis. • Discuss the treatment of multiple
• Describe the CSF findings in multiple sclerosis. sclerosis.
• Discuss the differential diagnosis of multiple sclerosis. • Discuss the leukodystrophies.
• Discuss the role of biopsy in
demyelinating disease.
Peripheral • Classify and describe the causes and • Describe the pathology and clinical features of herpes • Describe the neurophysiological findings
neuropathy clinical features of peripheral zoster infection. in the different neuropathies.
neuropathies. • Discuss the treatments of peripheral
neuropathies.
Peripheral • Discuss the physiology of EMG and • Describe the findings of EMG and nerve conduction • Describe the findings of EMG and nerve
electrophysiology nerve conduction studies. studies in lesions of peripheral nerves. conduction studies in myopathies.
• Interpret the EMG and nerve conduction
studies reports for the common
compressive neuropathies.
• Discuss the more specialised
neurophysiology findings (such as H-
waves).

Toxic and deficiency • Describe the more common vitamin • Discuss the pathology of Wernicke's encephalopathy. • Discuss the treatment of toxic and
disorders of the deficiencies. • Discuss the pathology of subacute combined deficiency disorders of the nervous
nervous system • Describe the effects of alcohol on the degeneration of the spinal cord. system.
nervous system. • Discuss the neurological effects of metal
• Discuss the clinical management of poisoning.
alcohol intoxication and alcohol
Paraneoplastic • Describe the general concepts of the • Discuss the clinical features and theories of • Discuss specific paraneoplastic
syndromes paraneoplastic syndromes. pathogenesis of paraneoplastic syndromes. syndromes, including subacute cerebellar
• Describe the pathology of Eaton-Lambert syndrome degeneration, spinal cord and dorsal root
and neoplastic ADH production. ganglia syndromes, and peripheral
neuropathy.
Extra pyramidal • List the spectrum of diseases related • Discuss other extrapyramidal movement disorders, • Discuss the surgical treatments for
disorders to basal ganglia pathology. including chorea, hemiballismus, athetosis, and Parkinson's disease, including the
• Describe the clinical features, dystonias. indications and the effects of lesions in
pathogenesis and epidemiology of different sites.
Parkinson's Disease. • Discuss the rationale for lesion generation
• Discuss the uses and limitations of versus stimulator implantation in
pharmacological therapy for movement disorder surgery.
Parkinson's Disease. • Discuss the use of cell transplant therapy
for Parkinson's Disease.
• Discuss emerging treatment modalities
for the surgical treatment of movement
disorders.
Diseases of muscle • Describe the structure and • Describe the gross and microscopic pathology of • Describe the infectious and toxic causes
physiology of normal muscle. common myopathies. of myopathy.
• Describe the common muscular • Describe the clinical features, epidemiology and • Discuss the role of muscle biopsy in the
dystrophies. natural history of inflammatory myopathies. diagnosis of myopathies.
• Describe the association between inflammatory • Discuss the general principles of
myopathy and diseases such as SLE, polyarteritis mitochondrial diseases.
nodosa, rheumatoid arthritis, and scleroderma. • Describe the endocrine causes of
• Describe the diagnosis, pathophysiology, myopathy.
investigation and treatment of myasthenia gravis. • Describe the general principles of familial
and periodic paralysis.

SYLLABUS MODULE – INFECTION
Primary bacterial • Describe the clinical and diagnostic • Describe the clinical and diagnostic features of spinal • Describe the common long term
infections features of bacterial meningitis. epidural abscess. neurological sequelae following bacterial
• List the common responsible • Discuss the mechanisms by which spinal epidural meningitis and intracerebral abscess.
pathogens for bacterial meningitis, abscess can cause neurological deficit. • Compare and contrast aspiration and
pathogenesis and appropriate • Discuss in detail the management options for spinal surgical excision of intracerebral abscess.
antibiotic management. epidural abscess. • Describe the neurological manifestations
• Describe the clinical and diagnostic • Discuss the prognosis for spinal epidural abscess. of syphilis.
features of cerebral abscess. • Describe the clinical and diagnostic features of spinal • Discuss the role of immunisation and
• List the common responsible osteomyelitis. prophylactic antibiotics in the prevention
pathogens for cerebral abscess, • Discuss in detail the management options for spinal of bacterial meningitis in the community.
pathogenesis and appropriate osteomyelitis.
antibiotic management. • Discuss in detail mycobacterial infection of the spine
• Discuss clinical conditions and CNS.
predisposing to the development of • Discuss the pathogenesis, clinical and diagnostic
bacterial meningitis. features of primary discitis.
• Discuss clinical conditions • Discuss the management options and long term
predisposing to the development of outcome for primary discitis.
cerebral abscess. • Discuss paranasal sinus infections and its relevance to
• Describe in detail the clinical CNS and skull infection.
management of acute bacterial • Discuss the features of subdural abscess particularly
meningitis. in paediatric population and its management.
• Describe the management options
for intracerebral abscess.
• Discuss the indications and
contraindications of lumbar puncture
in patients with CNS infections.
Primary viral • Discuss the various viruses • Discuss prion diseases affecting the human CNS, • Discuss the CNS sequelae of in-utero viral
infections responsible for viral encephalitis. including clinical features, diagnostic features, infection.
• Describe the clinical presentation, management and infection control. • Discuss the current NH&MRC Guidelines
diagnostic features, pathogenesis • Discuss the role of biopsy in prion disease. regarding prevention and management of
and management of viral meningitis. CJD.
• Describe neurological complications • Discuss the spectrum of neurological
of HIV infection. conditions associated with herpes viral
• Discuss the various causes of infections.

immune compromise. •
Primary • Discuss the various fungal and • Discuss the pathogenesis and management of hydatid • Describe the pathogenesis, diagnostic
fungal/parasitic parasitic infections that can affect disease of the brain. features, clinical features and
infections the central nervous system. • management for cryptococcal CNS
• Describe predisposing factors to infection .
fungal/parasitic infections of the •
CNS. •
Postoperative and • Discuss the common causes, • Discuss the common causes, diagnosis, predisposing • Discuss in detail the evidence for various
post traumatic diagnosis, predisposing factors and factors and management of shunt infections. measures to decrease operative
infections management of postoperative and • Discuss the evidence regarding the use of infections
post traumatic wound infections. prophylactic antibiotics following trauma and • Discuss the management options, and
• Discuss the common organisms neurosurgical procedures (contaminated and clean). evidence for their effectiveness, for an
responsible for post operative and • infected shunt.
post traumatic infections. •
SYLLABUS MODULE – NEUROANAESTHESIA
General • Demonstrate emergency airway • Discuss awareness under anaesthesia. • Discuss the anaesthetic precautions and
anaesthesia: effect management including intubation, • Discuss the variations on anaesthetic induction risks in the sitting position.
on I.C.P. and medications, tube sizes etc. appropriate for patients with raised intracranial • Describe the anaesthetic detection and
• Discuss the uses of premedication in pressure. treatment of air embolism.
cerebral blood flow
neurosurgical patients. • Discuss the variations on anaesthetic induction
• Describe the agents used in appropriate for patients with potentially unstable
induction of general anaesthesia. cervical spine.
• Describe drugs used for the • Describe specific anaesthetic manoeuvres which may
maintenance of general anaesthesia be used to reduce intracranial pressure.
including inhalational and • Describe in basic terms the ASA classification.
intravenous agents. • Discuss the anaesthetic precautions and risks in the
• Discuss drugs used for neuro lateral and prone positions
muscular blockade including
monitoring and reversal.
• Discuss the role of hypnotics,
analgesics, anaesthetic agents and
muscle relaxants.

Regional • Discuss the indications for the use of • Discuss the uses and risks associated with epidural • Discuss the use of regional anaesthesia in
anaesthesia regional anaesthesia in neurosurgical anaesthetic and epidural analgesia. awake craniotomy.
patients.
• Discuss the role of neuroleptic
agents in addition to regional
anaesthesia.
• Discuss the use of adrenaline with
local anaesthetics.

SYLLABUS MODULE – NEUROANATOMY
Development of the • Describe the development of an • Discuss the differences between the foetal and adult • Discuss the embryological basis for
nervous system - embryo to week three. cerebral circulations. cerebral arteriovenous malformations.
neuroembryology • Describe in detail the embryological • Discuss the embryological basis for spinal • Discuss the embryological basis for
development of the notochord, dysraphism. craniopharyngioma and Rathke's cleft
neural tube and neural crest into the • Discuss the development of the cerebral cyst.
mature nervous system. microcirculation. • Discuss theories of the embryological
• Describe the recognisable divisions • Describe the embryological development of the basis for colloid cysts.
and subdivisions of the developing pituitary gland. • Discuss the embryological basis for
brain. neuroectodermal cysts.
• Describe the folding of the forebrain • Discuss the embryological basis for
into the mature cerebral cerebral heterotopias.
hemispheres.
• Describe the embryological
development of the skull and face.
• Describe the embryological
development of the vertebral
column.
• Describe the spinal cord levels
relative to the vertebral column
during development to adulthood
Cellular components • Describe the ultrastructure of a • Describe the anatomy of the different types of
of the nervous neurone. ganglia.
system - histology • Describe the different types of • Describe the ultrastructural anatomy of the
neurones. interneuronal junctions and the neuromuscular
• Describe the layers of the cerebral junctions.
and cerebellar cortices. • Describe the anatomy of the alpha motor neurone in
• Describe the ultrastructure of the the spinal cord.
blood-brain barrier. • Describe the classification, histological features and
function of the neuroglia.

Gross anatomy of • Describe the gross anatomy of the • Describe the gross and functional anatomy of the • Discuss, in general terms, the degree of
the cranium and frontal lobe with particular reference corpus callosum and commissures. eloquence of the named portions of the
brain to boundaries, surfaces, anatomy • Describe the anatomy of the insular lobe. frontal lobe.
relative to the skull and named • Describe the anatomy of the external capsule and • Describe the relationship of the gyrus
surface structures. claustrum. rectus to the anterior communicating
• Describe the functions of the frontal • Describe the anatomy of the corona radiata and the artery.
lobe and their topographical internal capsule with particular respect to the arterial • Describe the connections of the
representation. supply of the latter. hippocampus.
• Describe the arterial supply and • Discuss the concepts of dominance and non- • Discuss the anatomical connections
venous drainage of the frontal lobe. dominance. between the basal ganglia.
• Describe the gross anatomy of the • Describe the anatomy of the hippocampus in terms of • Describe the anatomy, connections and
parietal lobe with particular its position, and layers. function of the reticular formation.
reference to boundaries, surfaces, • Describe the components of the basal ganglia and • Describe the anatomy of the thalamus
anatomy relative to the skull and their relationships. including its important nuclei.
named surface structures. • Describe the components of the limbic system. • Describe the surgical anatomy of the
• Describe the functions of the parietal • Diagramatically illustrate the internal structure of the pineal region.
lobe and their topographical midbrain at the levels of the superior colliculus and • Discuss the anatomical basis for
representation. the inferior colliculus. personality.
• Describe the arterial supply and • Describe the arterial supply of the midbrain. • Discuss the anatomical and physiological
venous drainage of the parietal lobe. • Diagramatically illustrate the internal structure of the basis for memory, both short and long
• Describe the gross anatomy of the pons at the levels of the upper pons and the lower term.
occipital lobe with particular pons.
reference to boundaries, surfaces, • Describe the arterial supply of the pons.
anatomy relative to the skull and • Diagramatically illustrate the internal structure of the
named surface structures. medulla at the levels of the closed medulla, upper
• Describe the functions of the part of the open medulla and the lower part of the
occipital lobe and their topographical open medulla.
representation. • Describe the arterial supply of the medulla.
• Describe the arterial supply and • Diagramatically illustrate and describe the anatomy of
venous drainage of the occipital the floor of the fourth ventricle.
lobe. • Describe the deep nuclei of the cerebellum.
• Describe the gross anatomy of the • Describe the anatomy of the floor of the third
temporal lobe with particular ventricle.
reference to boundaries, surfaces, • Describe the anatomy of the hypothalamus including
anatomy relative to the skull and its connections and named nuclei.
named surface structures.
• Describe the gross anatomy of the
cerebellum with particular respect to
named surface structures,
connections, arterial supply and
venous drainage.

• Describe in detail the anatomy of the

pituitary gland including the stalk.
• Describe the external relationships
of the cerebral peduncles.
of the midbrain.
of the pons.
of the medulla.
Gross anatomy of • Describe the anatomy of the scalp • Describe the surgical anatomy of the temporalis • Describe the surgical anatomy of the
the scalp, the skull including blood supply, innervation muscle and its fascia. temporal bone.
and associated and muscles. • Discuss the surgical anatomy of the pterion and the • Describe the anatomy of the structures
• Describe the gross anatomy of the lateral portion of the lesser wing of the sphenoid encountered during the far lateral
muscles
individual bones of the skull. bone. transcondylar approach to the posterior
• Describe the contents of the • Describe the anatomy, relationships and approaches fossa.
foraminae of the skull. to the anterior clinoid process. • Describe in detail the anatomy of the
• Describe the anatomy of the structures of the internal superior orbital fissure.
acoustic meatus. • Describe in detail the anatomy of the
• Describe the anatomy of the structures of the jugular foramen.
craniocervical junction (C0 - C2) including the • Describe the anatomy of the structures
foramen magnum. encountered in the translabyrinthine
• Describe the regional anatomy of the nose, sphenoid approach for lesions of the
sinus and pituitary fossa. cerebellopontine angle.
• •
Gross anatomy of • Describe the coverings of the brain • Describe the location, tributaries and outflow of the • Discuss the relative surgical importance
the dura, its and spinal cord. dural venous sinuses. of the dural venous sinuses in terms of
reflections and • Describe the layers of the dura and • Describe the dural reflections of the middle cranial the options for sacrifice.
how they separate to form the fossa. • Discuss the anatomical basis for acute
venous spaces
superficial dural venous sinuses. • Describe the dural reflections as they form the venous congestion syndromes associated
• Describe the reflection of the dura to cavernous sinus. with occlusion of different venous
form the falx cerebri and the • Discuss the regional anatomy of the tentorial hiatus. sinuses.
tentorium cerebelli. • Describe the dural anatomy of the superior petrosal • Describe the anatomy of the Dolenc
• Discuss the attachments and sinus and Meckel's cave. approach to the cavernous sinus.
relationships of the free edge of the • Describe the vascular and nervous supply of the dura. • Describe in general terms the triangles of
tentorium cerebelli. • Describe the anatomy of the dural rings around the possible lateral entrance to the cavernous
• Describe the anatomy of the internal carotid artery. sinus.
arachnoid villi. • Describe the anatomy of the dura related to the
pituitary fossa.
• Discuss the dominant flow from the superior sagittal
sinus to the transverse sinuses.

The cranial nerve • Tabulate the functions of each of the • Assign the nucleus responsible for each of the • Describe the anatomical basis for the
and their nuclei cranial nerves under the headings functions of the cranial nerves. clinical features of injury to various parts
somatic motor, somatic sensory, • Outline the anatomy and functions of each of the of the facial nerve.
autonomic motor, autonomic nuclei related to cranial nerves. • Describe the anatomy of the cranial
sensory and special sensory. • Describe in detail the anatomy of the cranial nerves nerves of the cerebellopontine angle as
• Identify the attachment of the as they connect the nuclei. visualised in an approach to the
cranial nerves to the brain. • Tabulate the cranial nerves which attach to the trigeminal nerve above the cerebellum.
• Describe the anatomy of the cranial midbrain, pons, pontomedullary junction and the • Describe the anatomy of the cranial
nerves external to the brain medulla. nerves as visualised in a retrosigmoid
(intracranial and extracranial • Describe the meningeal relationships to the optic suboccipital approach to the
course). nerve as it pertains to the development of cerebellopontine angle.
papilloedema. • Describe the anatomy of the cranial
• Describe the blood supply of the optic nerve. nerves of the cerebellopontine angle as
• Describe the relationships of the subarachnoid visualised in a translabyrinthine
oculomotor nerve. approach.
• Describe the blood supply of the facial and • Describe the anatomy of the lower cranial
vestibulocochlear nerves. nerves as visualised in a far lateral
transcondylar approach.
The CSF filled • Describe, in general terms, the • Name and describe in detail the anatomy of each of • Describe the anatomy of the choroidal
spaces anatomy of the arachnoid cisterns. the arachnoid cisterns. fissure.
• Describe, in general terms, the • Describe the detailed anatomy of the Sylvian Fissure. • Describe in detail the anatomy of each of
anatomy of the ventricular system • Describe the histological anatomy of the choroid the ventricles and the Aqueduct of
including the choroid plexus. plexus. Sylvius.
• Describe the relevant anatomy • Discuss the landmarks for navigation
associated with ventricular puncture. within the lateral ventricle.
• Describe the anatomy of the approaches
to the third ventricle.
Foramen of Monro as it pertains to
surgical access to the third ventricle.
The arterial supply • Describe the anatomy of the aortic • Discuss the relationship of the internal carotid artery • Describe the anatomical variants of the
and venous arch and list its branches. to the middle ear. cerebral arteries such as persistent
drainage of the • Describe the anatomy of the • Describe in detail the intradural microsurgical trigeminal artery.
external carotid artery, its branches anatomy as exposed in a pterional craniotomy. • Discuss the anatomical variations of the
cranium and brain
and describe the anatomy of the • Describe in detail the anatomy of the perforating posterior communicating artery and its
major branches. vessels arising from the anterior cerebral circulation. relationship to the oculomotor nerve.
• Describe the anatomy of the • Describe the anatomy of the anatomy of the anterior • Describe the anatomy exposed in the
extracranial internal carotid artery. choroidal artery. approaches to the basilar artery.
• Describe the anatomy of the internal • Discuss the normal variations of the anterior • Describe the vascular relationships to the
carotid artery in the skull base and communicating artery complex. trigeminal, facial and glossopharyngeal

the cavernous sinus. • Describe the anatomy of the vertebral artery in the nerves as they pertain to microvascular
• List the branches of the neck. compression syndromes.
supracavernous internal carotid • Describe the detailed anatomy of the vertebral artery • Describe the venous anatomy as
artery. at the craniocervical junction. encountered in a supracerebellar
• Describe the anatomy of the • Describe the course, branches and relationships of infratentorial approach to the pineal
ophthalmic artery. the intradural vertebral artery. gland.
• Describe the anatomy of the • Describe the anatomy of the posterior inferior
posterior communicating artery. cerebellar artery including normal variants of origin.
• Describe the surgical anatomy of the • Describe the anatomy of the basilar artery and its
anterior cerebral artery and its branches.
branches. • Describe the anatomy of the anterior inferior
• Describe the surgical anatomy of the cerebellar artery.
middle cerebral artery and its • Describe the anatomy of the superior cerebellar
branches. artery.
• Describe the anatomy and • Describe the surgical anatomy of the posterior
significance of the Circle of Willis cerebral artery.
including its common variants. • Describe in detail the anatomy of the perforating
• Discuss in general terms the vessels which arise from the posterior circulation.
cerebral venous outflow including • Describe the anatomy of the anterior and posterior
the concepts of superficial and deep perforated substance.
drainage systems. • Describe the anatomy of the veins confluent on the
• Describe the anatomy of the Foramen of Monro.
superficial venous system. • Describe the anatomy and relationships of the
• Discuss the surgical significance of internal cerebral vein.
the vein of Labbé, vein of Trolard • Describe the anatomy and relationships of the basal
and Rolandic vein. vein of Rosenthal.
• Describe the surface anatomy of the • Describe the anatomy and relationships of the vein of
superior sagittal sinus, torcula, Galen.
transverse sinus and sigmoid sinus.
Gross anatomy of • Describe the bony anatomy of the • Describe the bony anatomy peculiar to each of the • Describe the anatomy of the cervical
the vertebral vertebral column. cervical, thoracic, lumbar, sacral and coccygeal lateral masses and facet joints.
column, the spinal • Describe the anatomy of the portions of the vertebral column. • Describe the anatomy and orientation of
ligaments of the vertebral column • Discuss the surface anatomy of the levels of the the thoracic pedicles relative to the
cord and associated
including the joint capsules. vertebral column. costotransverse structures and the
structures • Describe the anatomy of the • Discuss the blood supply of the intervertebral discs vertebral body.
intervertebral discs including the and its relationship to sepsis. • Describe the anatomy and orientation of
biochemical and histological changes • Discuss Batson's plexus and its role in the the lumbar pedicles relative to the
with age. dissemination of malignancy. transverse processes and the vertebral
• Discuss the arterial supply and • Discuss the anatomy of the occipito-cervical junction body.
venous drainage of the vertebral (C0 - C2). • Describe the anatomy and orientation of
bodies. • Discuss the biomechanics of the vertebral column the sacral pedicles relative to the ala of

• Discuss the anatomy of the vertebral with particular reference to the internal axis of the sacrum (S1) and the sacral
end-plate. rotation, sagittal alignment and the moment arms of foraminae.
• Describe the anatomy of the muscles the spinal musculature. • Describe the innervation of the
attaching to the vertebral column, • Describe in detail the white matter tracts, and their intervertebral discs.
posterior to and including the connections, of the spinal cord. • Describe the innervation of the facet
posterior portion of the transverse • Describe in detail the functional sections of the grey joints.
processes. matter. • Discuss the function of the facet joint as
• Describe the anatomy of the muscles • Diagrammatically illustrate the cross-sectional its varies between the cervical, thoracic
attaching to the vertebral column anatomy of the spinal cord at the mid-cervical, mid- and lumbar regions.
anterior to the posterior portions of thoracic and low-thoracic vertebral levels. • Describe the anatomical basis for correct
the transverse processes. • Describe the arterial supply of the spinal cord and its level localisation in the thoracic spine
• Describe the general anatomy of the relationship to known arterial supply deficiency during thoracotomy procedures.
spinal cord with respect to the zones syndromes.
of grey and white matter, • Describe the surgical anatomy of the Artery of
relationship of spinal nerves to the Adamkiewicz.
vertebral column levels, ligament • Describe the position on the trunk and limbs of the
attachments, dorsal root entry zone, key sensory levels of the spinal cord.
the conus medullaris and filum
terminale.
• Describe the detailed anatomy of the
spinal nerve including its dorsal root
ganglion in the region of the
intervertebral foramen.
• Discuss the rib articulations with the
vertebral column.
Gross anatomy of • Describe the anatomy of the brachial • Discuss in detail the surgical anatomy of the common
the peripheral plexus. exposures of the peripheral nerves.
somatic nervous • Describe in detail the anatomy of the • Describe the anatomy of the thoracic outlet with
nerves of the upper limb including particular reference to vascular and neurological
system
their relationships. compression syndromes.
• Describe the surgical anatomy of the
ante-cubital fossa.
• Describe the surgical anatomy of the
cubital tunnel and Guyon's canal.
volar aspect of the wrist and the
carpal tunnel.
• Demonstrate the dermatomes and
myotomes of the upper limb, trunk
and lower limb.
• Describe the anatomy of the

lumbosacral plexus and its branches

within and exiting the pelvis.
nerves of the lower limb including
their relationships.
• Describe the anatomy of the femoral
triangle, popliteal fossa and tarsal
tunnel.
Gross anatomy of • Discuss the anatomy and function of • Describe the origins and pathways of sympathetic • Discuss the anatomy exposed in a
the autonomic the sympathetic nervous system. supply in the central nervous system. transthoracic endoscopic cervical
nervous system • Discuss the anatomy and function of • Describe the anatomy of the sympathetic chain sympathectomy.
the parasympathetic nervous including its connections to the spinal cord and
system. regions of supply.
• Describe the origins and pathways of the
parasympathetic nervous system in the central
nervous system.
• Describe the parasympathetic ganglia of the head and
neck.
• Describe the parasympathetic supply of the thorax.
• Describe the parasympathetic supply from the
lumbosacral region.
• Discuss the innervation of the urinary bladder.
Radiological • Describe the normal radiological • Identify anatomical structures on axial, coronal and • Demonstrate the vessels visible on spinal
anatomy of the appearance of the prevertebral soft sagittal sections of the brain. angiography.
cranium, vertebral tissue of the cervical spine. • Identify the anatomical structures visualised with 2- • Demonstrate the anatomy visible with
• Describe the normal radiological dimensional angiography. ventricular and cisternal contrast
column and the
distances in the occipito-cervical (C0 • Identify anatomical structures as represented in 3- injection.
central nervous - C2) junction in all ranges of normal dimensional imaging.
system motion. • Identify anatomical structures on axial, coronal and
• Identify the normal anatomical sagittal sections of the spine.
structures visible on plain radiology
of the cervical, thoracic and
lumbosacral spine.
Pathways • Describe the motor pathways within • Describe the auditory pathways. • Describe the anatomical basis for extra-
the central nervous system. • Describe the pathway subserving pupillary responses. pyramidal motor control
• Describe the somatic sensory • Describe the neurological pathways for
pathways within the central nervous speech.
system. • Describe the pathways for conjugate eye
• Describe the visual pathways. movement.

SYLLABUS MODULE – NEURO-ONCOLOGY
Tumours of the • List the classification of tumours that • Describe the histopathological features of scalp and • Describe in detail the management
scalp and skull vault occur at the skull vault and scalp. skull tumours. options (surgical and non-surgical) for
• Describe epidemiology, clinical • Describe findings of appropriate preoperative skull vault and scalp tumours.
presentation and natural history of investigation (including neuroradiological findings) of • Demonstrate the surgical management of
scalp and skull tumours. benign and malignant scalp and skull tumours. skull vault and scalp tumours.
• Perform a history, examination and • Describe the differential diagnosis of lytic and
pre-operative workup of patients sclerotic skull lesions.
with tumours of scalp and skull.
• List the appropriate pre-operative
investigations.
Cell kinetics, • Describe the nature of cell division • Describe factors secreted by tumours which modulate • Describe imaging techniques that
genetics and and the cell cycle. the immune response and cause immunodeficiency examine cell kinetics of brain tumours.
immunology of • Describe the abnormalities of the cell and the mechanisms by which they do this. • Describe common immunological deficits
cycle commonly identified in • Describe commonly used histopathological markers of in patients treated for neurological
neurological
neoplasia. cell kinetics and their significance. tumours.
tumours • Define terms "benign", "neoplastic" • Describe the immune deficiency syndromes in relation • Discuss immune based adjuvant
and "malignant" as relevant to to neurological tumours. therapies with patients and refer them
neurological tumours. appropriately.
• Define "tumour suppressor gene", • Describe the possible indications for
"oncogene", "loss of heterozygosity", immune system based therapy.
"growth factor", "growth factor • Describe current theories concerning
receptor", and "cytokine". List apoptosis and necrosis.
examples of each under current • Discuss the biological basis for anti-
investigation and explain their tumour vaccines in treatment of
significance to common CNS neurological tumours (primary and
neoplasms. secondary).
• Define tumour invasion and • Evaluate the literature on immune based
angiogenesis and describe the system therapy and gene therapy as
underlying mechanisms. Discuss the relates to neuro-oncology.
significance of each to tumour
progression for common CNS
neoplasms.
• Describe the impact of tumour

invasion and tumour biology on the

accuracy of biopsy of CNS tumours
• Define "tumour markers" and their
use in clinical practice.
• Describe elements of immune
system and immune response to
brain tumours.
• Define "cytokine", "autocrine' and
"paracrine".
• Define the blood brain barrier and
discuss the immune privilege and
immune quiescence of the brain.
Discuss the consequences of
disruption of the blood brain barrier
and the mechanisms by which it may
occur.
• Define "tumour markers" and
principles of their clinical use.
• Describe elements of immune
system and immune response to
brain tumours.
• Define tumour marker and discuss
those relevant to CNS tumours and
the difficulty of defining true
tumour-associated antigens in the
CNS.
• Describe the immune deficiency
syndrome related to CNS tumours,
particularly malignant astrocytoma.
Describe the clinical features and
laboratory examinations
abnormalities.
• Define "cytokine", "autocrine' and
"paracrine". Describe factors
secreted by tumours which modulate
the immune response and cause
immunodeficiency and the
mechanisms by which they do this.
• Describe the mechanisms of action
of commonly used medications for
patients with CNS tumours and the
effect on the immune system, in

particular, glucocorticoids and

anticonvulsants.
• Define the blood brain barrier and
discuss the immune privilege and
immune quiescence of the brain.
Discuss the consequences of
disruption of the blood brain barrier
and the mechanisms by which it may
occur.
Classification and • Describe the history of brain tumour • Outline the current WHO system for brain tumour • Describe in detail current WHO
epidemiology of classification systems. classification. classification for neurological tumours.
cerebral tumours • Describe different systems for • Identify on pathological slides the features on which • Describe common XRT-induced brain
classification of astrocytomas. classification of tumour type and tumour grade are tumours - epidemiology, pathology and
• Discuss the incidence of brain based - particularly for common tumours including investigation.
tumours. gliomas, meningiomas, metastases, pineal region • Discuss controversies in tumour
• Summarise the epidemiology, tumours, acoustic neuroma, pituitary tumours and classification and review the literature of
incidence and risk factors for craniopharyngioma. those encountered in clinical practice.
common CNS neoplasms. Discuss • Describe the general relationships of tumour • Describe the risks of developing a CNS
the influence of gender, ethnicity, classification with management and prognosis. tumour based on environmental or
age, occupation and predisposing Discuss the influence of tumour type, tumour grade, medical exposure to viruses, chemical or
conditions (such as the tumours site, age at presentation and neurological radiation.
phakomatoses or other genetic function at time of presentation.
syndromes).
• Discuss the use of tumour grade
within the classification
• Discuss the differential diagnosis of
brain tumour - list non-neoplastic
lesions that may clinically or
radiologically mimic a brain tumour.
• Describe the multistep nature of
tumour pathogenesis in general
terms.
• Describe the basis of general
tumourigenesis by viruses,
chemicals and radiation.
Neurophakomatoses • List the conditions known as • Describe in detail the definition, genetic basis, • Identify the macroscopic and microscopic
neurophakomatoses. pathology, clinical features and natural history of the differences between neurofibromas and
• Outline the classification of neurophakomatoses schwannomas.
Neurofibromatosis I and II, its • Describe the long-term risks and complications of the • Discuss the indications for intervention in
incidence and genetic characteristics neurophakomatoses and the neoplasms associated the treatment of neurofibroma in patients

and diagnostic criteria used to with them. with neurofibromatosis.

identify subjects. • Discuss the genetic testing and prenatal diagnosis • Describe biochemistry and function of
• Perform a history, examination and available for neurophakomatoses. neurofibromatosis I protein
pre-operative workup of patients (neurofibroma) and Neurofibromatosis I
with neurophakomatoses. protein (schwannoma/merlin).
• Demonstrate the clinical findings in a • Provide genetic counselling for a patient
patient with a neurophakomatosis. with neurofibromatosis.
• Discuss the indications for intervention in
the treatment of conditions in patients
with neurophakomatoses other than
neurofibromatosis.
Gliomas • Define the term glioma. • Describe the gross and histopathological features of • Identify the common histological features
• Describe the clinical presentation of gliomas. used to classify gliomas such as
a patient with glioma with • Interpret investigations in patients presenting with "gemistocyte", "necrosis", "mitosis",
consideration of grade and location. suspected glioma. "anaplasia", "endothelial hyperplasia",
• Perform a history, examination and • Describe the common types of adjuvant therapy for "Rosenthal fibres", "pilocytes",
pre-operative workup of patients gliomas and the indications for them. "palisading", "rosettes" and
with supratentorial gliomas. "pseudorosettes".
• List the appropriate investigations of • Describe the role of surgery and adjuvant
a patient with glioma. therapy for gliomas and the effect on
• List the clinical features, natural natural history/efficacy.
history and prognosis of optic nerve • Discuss in detail the commonly available
glioma and the conditions with which adjuvant therapies for glioma.
it is associated. • Discuss the indications for re-operation in
• List the clinical features, natural recurrent glioma.
history and prognosis of • Describe, differentiate and compare the
hypothalamic glioma and the different techniques for excision,
conditions with which it is including ultrasonic aspiration, laser and
associated. suction.
• Describe the clinical management of
uncommon glial and mixed glial/neuronal
tumours for example: gliomatosis cerebri,
giant cell glioblastoma, gliosarcoma,
pleiomorphic xanthoastrocytoma,
subependymal giant cell astrocytoma,
subependymoma, desmoplastic infantile
ganglioglioma, DNET, ganglioglioma,
gangliocytoma, hypothalamic
hamartoma, protoplasmic astrocytoma,
paraganglioma, and glioneurocytoma.
• Critically evaluate the emerging and

controversial adjuvant therapies for

glioma.
• Discuss controversies in the management
of glioma including surgical management
and adjuvant therapy of low grade
gliomas, extent of surgical resection and
biopsy vs. excision and timing of adjuvant
therapy. Evaluate the literature on these
issues and state a summary and
conclusion.
• Discuss the role of surgery in the
management of tumours of the brain
stem.
• Critically evaluate the controversial issues
in the management of brainstem glioma.
Intraventricular • List the tumours that may appear • Describe the gross and histopathological features of • Describe role of surgery for treatment of
tumours within the ventricular system by intraventricular tumours. medulloblastoma and ependymoma of
location. • Interpret investigations in patients presenting with posterior fossa.
• Describe the clinical presentation of intraventricular tumours. • Discuss the management of an incidental
masses within the ventricular • Describe the distinguishing features of fourth lesion in the third ventricle, with
system. ventricular tumours including medulloblastoma and particular reference to colloid cyst.
• Perform a history, examination and ependymoma. • Discuss the management of an incidental
pre-operative workup of patients • Describe the distinguishing features of third lesion in the lateral ventricle.
with an intraventricular tumour. ventricular tumours including colloid cysts. • Critically evaluate the literature regarding
• List the appropriate investigations of • Describe the distinguishing features of lateral developing and experimental adjuvant
a patient with an intraventricular ventricular tumours including meningioma and therapy for medulloblastoma and
tumour. choroid plexus tumours. ependymoma.
• Discuss the mechanisms of • Describe the types of adjuvant therapy and their role • Describe high and low risk
development of hydrocephalus in in the treatment of childhood ventricular tumours. medulloblastoma patients and the
intraventricular tumours. appropriate adjuvant therapy for these
• Describe the principles of groups.
management of acute ventricular • Describe appropriate adjuvant therapy for
obstruction. ependymoma.
• Discuss grading of ependymomas and its
significance.
Metastatic brain • List the tumours that tend to • Describe the gross and histopathological features of • Independently determine a differential
tumours metastasize to the central nervous cerebral metastases. diagnosis and comprehensive treatment
system with particular reference to • Interpret investigations in patients presenting with plan for patients with metastases based
age and gender. metastatic disease of the central nervous system. on history, examination, laboratory
• Describe the clinical presentation of • Describe the common types of adjuvant therapy for examinations and radiology.

patients with metastatic disease to with metastatic disease of the central nervous • Discuss the role of surgery for solitary
the central nervous system. system. and multiple intracerebral metastases.
• Perform a history, examination and • Describe primary brain tumours that metastasise to • Describe role and types of radiation
pre-operative workup of a patient CSF and extraneural pathways involved. treatment in the management of
with metastatic disease of the intracerebral metastases, including
central nervous system. stereotactic radiotherapy.
• List the appropriate investigations of
a patient with metastatic disease of
the central nervous system.
• Describe current theories of
metastatic spread of tumours to the
central nervous system.
Meningioma • Describe current WHO classification • Describe macroscopic and histological features of • Discuss the role of radiation treatment in
of meningiomas. meningiomas. the management of meningiomas.
• Describe the common intracranial • Discuss the clinical significance of pathological sub • Discuss non-radiation based adjuvant
locations of meningioma and the types of meningiomas. therapies in the management of
expected presentation at each • Discuss the features of meningioma related to meningiomas.
location. prognosis such as extent of surgical resection, • Discuss the presentation, epidemiology,
• Discuss epidemiology of markers of proliferation, receptor status and pathology and management of
meningioma. histological grade. haemangiopericytoma.
• Define the cell of origin and • Discuss surgical goals in treatment of meningiomas • Discuss the management of meningiomas
cytogenetics of meningioma and and general principles of operation. related to the dural venous sinuses.
theories of tumourigenesis. • Describe the Simpson classification of surgical • Describe the pathological and clinical
• List the appropriate investigations of resection of meningiomas. features of uncommon tumours of the
a patient with meningioma • Interpret investigations in a patient presenting with meninges, including lipoma, angiolipoma,
meningioma. hibernoma, fibrosarcoma, fibromatoses,
fibrous histiocytoma, tumours of muscle
and cartilaginous origin, haemangioma,
angiosarcoma, epithelioid
haemangioendothelioma, Kaposi
sarcoma, melanocytoma, melanocytosis
and malignant melanoma.
• Discuss the difficulties associated with
managing a recurrent meningioma.
• Discuss role of pre-operative embolisation
in the surgical management of
meningiomas.
Epidermoids, • Define and differentiate epidermoid, • Identify the macroscopic and microscopic features of • Discuss the options for surgical and non-
dermoids and dermoid and teratoma. epidermoid, dermoid and teratoma. surgical management of dermoid and
teratoma • Describe common locations of • Identify the radiological features of epidermoid, epidermoid.

epidermoid and dermoid and the dermoid and teratoma. • Describe the indications for and types of
epidemiology of both. • Differentiate mature, immature and malignant adjuvant therapy for teratomas.
• List the clinical features, natural teratoma. • Describe the indications for complex
history and prognosis of resections of epidermoids, dermoids or
epidermoids, dermoids and teratomas, particularly those involving
teratomas. eloquent structures.
Pineal region • Describe the classification of pineal • Discuss the significance of pineal region tumour • Discuss the indications for and surgical
tumours region tumours including WHO. markers, age, gender and ethnic origin on options for pineal region tumours.
• Describe the clinical presentation of classification diagnosis and prognosis. • Describe the indications for and types of
a pineal region tumour. • Describe the classification of germ cell tumours and adjuvant therapy for pineal regions
• Discuss the appropriate tumour markers associated with these. tumours as related to pathological type,
investigations including age at presentation and ethnic origin
haematological, CSF and • Contrast appropriate management of
radiological. parenchymal and germ cell pineal
• Describe the incidence, classification tumours (germ/non-germ), (XRT,
and pathology of pineal region chemotherapy).
tumours.
• Describe the anatomy and
physiology of the normal pineal
gland and the embryology and
anatomy of pineal region tumours,
particularly the vascular supply and
adjacent important structures.
• Describe Parinaud's Syndrome and
its clinicopathological significance.
Cerebellopontine • List the tumours that may arise in • Identify the diagnostic radiological features of CPA • Discuss the role of stereotactic
angle tumours, the cerebellopontine angle (CPA). tumours. radiosurgery for management of CPA
especially vestibular • Describe the epidemiology and • Describe otological investigations required for CPA tumours.
clinical presentation and natural tumours. • Discuss indications for and types of
schwannoma
history of vestibular schwannoma. • Describe the gross and microscopic features of adjuvant therapy for CPA tumours as
(acoustic neuroma) • Discuss the association of vestibular vestibular schwannoma. related to pathological type.
schwannoma with other disorders, • Describe in detail surgical anatomy, risks
including NF-2 and the underlying and indications of different approaches
genetic abnormalities. for CPA tumours e.g. middle fossa,
• List other sites at which cranial suboccipital and translabyrinthine.
schwannomas can occur and • Discuss the management of a patient
compare and contrast with CPA with facial paresis.
schwannomas. • Discuss the uses and indications for
• Perform a history, examination and intraoperative monitoring during CPA
pre-operative workup of patients surgery.

with CPA tumours. • Discuss strategies of hearing preservation

• List the appropriate investigations of in CPA tumours.
a patient with a CPA tumour. • Discuss surgical management of different
• Describe the House-Brackmann types of hearing loss.
grading scale of facial nerve • Discuss the issues relating to the
weakness. management of patients with bilateral
vestibular schwannomas.
Haemangioblastoma • Describe the epidemiology, clinical • Describe the gross and microscopic features of • Describe the indications for and types of
presentation and natural history of haemangioblastoma. adjuvant therapy for haemangioblastoma.
haemangioblastoma. • Identify diagnostic radiological features of • Describe the on-going investigations,
• Describe the epidemiology, clinical haemangioblastoma. monitoring and genetic counselling of von
features and natural history of von Hippel Lindau disease.
Hippel Lindau syndrome. • Discuss strategies for managing
• Perform a history, examination and vascularity in recurrent
pre-operative workup of patients haemangioblastomas.
with haemangioblastoma. • Discuss the role of angiography and
• List the appropriate preoperative embolization in the management of
investigations of a patient with haemangioblastoma.
suspected haemangioblastoma. • Describe the function of the protein
product and the involved genetic defect in
von Hippel Lindau disease.
Pituitary and • Describe the classification of • Describe the gross and microscopic features of • Discuss in detail the indications for
parasellar tumours pituitary tumours with respect to the pituitary region tumours. surgery and the application of various
cell of origin and size. • Demonstrate the diagnostic radiological features of surgical approaches in management of
• Describe the clinical presentation pituitary region masses. pituitary region tumours.
and the epidemiology of pituitary • Perform and discuss the results of visual testing in • Discuss adjuvant treatment for pituitary
tumours. patients with pituitary lesions. tumours.
• List investigations of a patient • Discuss the significance of serum prolactin levels. • Discuss the adjuvant treatment for
presenting with a pituitary region • Describe the complications and long term risks of craniopharyngioma.
mass. endocrinopathies associated with pituitary tumours, • Discuss the differential diagnosis of
• Describe pituitary/hypothalamic both with and without treatment. patients with empty sella syndrome
emergencies including apoplexy, based on history, examination, laboratory
diabetes insipidus and Addisonian tests and radiology. Demonstrate the
crisis. List their causes and radiological abnormalities.
emergency management. • Discuss the management of CSF leak
• Perform a full endocrinological following pituitary region surgery.
assessment and demonstrate the • Discuss in detail the relationship of
medical management of common pituitary region lesions and their
endocrinopathies. management in relation to the treatment
• Describe the postoperative care of of fertility and pregnancy.

patients who have had pituitary

region surgery including fluid and
electrolyte management, hormone
replacement and assessment and
treatment of acute visual loss.
• Describe primary and secondary
empty sellar syndrome.
• Discuss the embryology of
craniopharyngioma and Rathke's
cleft cyst.
• Discuss the epidemiology, clinical
presentation and natural history of
craniopharyngioma and Rathke's
cleft cyst.
Chordoma • Discuss the embryogenesis of • Describe the gross and microscopic pathological • Discuss the therapeutic options in the
chordoma. features of chordoma. management of chordoma.
• Discuss location, epidemiology, • Describe the radiological features and differential • Discuss the potential difficulties
clinical features and natural history diagnosis of chordoma. associated with preoperative biopsy of
of chordoma. chordoma.
• Perform a history, examination and • Describe the indications for and types of
pre-operative workup of patients adjuvant therapy for chordoma.
with chordoma. • Discuss the implications of incomplete
resection for prognosis and adjuvant
therapy.
• Critically evaluate the literature on
evolving adjuvant therapies for the
management of chordoma such as boron
neutron capture therapy.
Tumours of the orbit • Perform a history, examination and • List the tumours that may arise in the orbit. • Independently determine a differential
pre-operative workup of patients • Describe the gross and microscopic pathological diagnosis and comprehensive treatment
with orbital tumours. features of tumours which may appear in the orbit. plan for patients with orbital tumours
• List the appropriate pre-operative • List the clinical features, natural history and based on history, examination, laboratory
investigations for a patient with prognosis of tumours and pseudotumours which occur tests and radiology.
orbital tumour. in the orbit. • Discuss the role for adjuvant therapy for
• Demonstrate the assessment of and orbital tumours.
discuss potential causes of proptosis. • Discuss in detail surgical approaches to
orbital lesions and their complications.
Lymphoma • Discuss the classifications of • Describe the gross and microscopic pathological • Discuss the role of surgery in cerebral
lymphoma. features of cerebral lymphoma and the current WHO lymphoma.

• Discuss the relationship between classification. • Discuss the effect of steroids in cerebral
lymphoma and associated conditions • Interpret the radiological features of cerebral lymphoma.
e.g. immunosuppression. lymphoma. • Discuss non-surgical treatments for the
• Describe the clinical features, management of cerebral lymphoma.
natural history and prognosis of
cerebral lymphoma.
Cranial and spinal • Describe the common locations in • Discuss the pathology of CNS lipomas. • Discuss the options for the management
lipoma which intracerebral and intraspinal of CNS lipoma.
lipomas occur, their anatomical
relationships and relative frequency
and embryological origin and
development.
• List the clinical features, natural
history and prognosis of
intracerebral and intramedullary
lipomas.
Spinal tumours • List the tumours that tend to • Demonstrate the radiological diagnostic features of • Discuss the indications for and types of
metastasize to the spine with spinal tumours. adjuvant therapy for spinal tumours
particular reference to age, gender • Describe the gross and microscopic pathological particularly related to pathology, site and
and frequency. features of spinal tumours. age at presentation.
• Classify the common extradural, • Discuss level localization in spinal tumour surgery. • Discuss the controversies surrounding
intradural (extramedullary) and • Discuss the indications for surgery, radiotherapy or intramedullary resective surgery.
intramedullary tumours. conservative approach in spinal tumours. • Discuss the role of neurophysiological
• Describe the clinical features of monitoring and spinal tumour surgery.
spinal tumours with specific • Discuss the role of pre-operative
reference to site and location. embolisation in the management spinal
• Discuss the natural history and tumours.
prognosis of tumours within the • Discuss the appropriate investigation and
spine, particularly as related to age differential diagnosis of a sacral mass.
at presentation and position in the • Discuss en-bloc resection of spinal
spine. tumours with respect to appropriate
• Perform a history, examination and indications, risks and complications.
pre-operative workup of patients • Radiotherapy and CNS tumours
with spine tumours. List the • Discuss the controversies concerning
appropriate pre-operative radiotherapy and neoplasia with
investigations. particular reference to metastases, low
• Discuss the management of a grade and benign tumours, paediatric
patient with acute spinal cord patients and the elderly.
compression. • Discuss the indications, efficacy and side-
effects of stereotactic radiosurgery and

stereotactic radiotherapy.
• Discuss the different delivery systems for
stereotactic radiosurgery.
Radiotherapy and • Describe the nature of ionizing • Describe indications for radiotherapy and treatment • Explain the rationale for fractionation in
CNS tumours radiation. of brain tumours. radiotherapy and describe
• Describe the different types of • Describe the indication for each type of radiotherapy radiosensitisers.
ionizing radiation and their short and as related to tumour type, position and patient age. • Discuss the clinical presentation,
long term effects on normal and investigation, differential diagnosis and
neoplastic tissue. management of radionecrosis.
• Describe the mechanisms by which • Describe common doses and dose
radiotherapy induces cell death. regimens for treatment of gliomas.
• Describe and compare the sources of
radiation commonly used in medical
applications.
• Describe and differentiate whole
brain radiotherapy, stereotactic
radiosurgery, stereotactic
radiotherapy, 3-D conformal
radiotherapy, intensity modulated
radiation therapy and interstitial
brachytherapy.
Chemotherapy • Discuss the basic principles of cancer • List the commonly used drugs in central nervous • Describe the role of chemotherapy in
chemotherapy. system tumour chemotherapy. paediatric brain tumour patients.
• Describe the side effects of • Explain the rationale for multidrug therapy. • Explain the indications for and risks and
chemotherapy and the management • Discuss the influence of the blood brain barrier on benefits of chemotherapy to individual
of these. chemotherapy delivery. patients with CNS tumours.
• Describe the mechanism of action of
commonly used drugs in central nervous
system tumour chemotherapy, with
particular reference to alkylating agents
(particularly the nitrosureas and
temozolamide), antimetabolites, vinca
alkaloids, podophyllotoxins, antibiotics,
platinum compounds, tamoxifen and
hydroxyurea.
• Describe the role of intracavitary
chemotherapy for the treatment of brain
tumours.
• Discuss the evidence for the efficacy of
chemotherapy for brain tumours.

• Discuss drug delivery to the central

nervous system and recent development
of new methods - including intra-arterial
delivery, blood brain barrier modification
and intracranial/local delivery
SYLLABUS MODULE – NEURO-OPHTHALMOLOGY
Neuro- • Describe in detail the visual • Discuss the mechanism and differential diagnosis of • Discuss neurological causes of alexia.
ophthalmology pathways. nystagmus. •
• Describe the neurological control of • Describe the diagnostic significance of different types
conjugate eye movement. of nystagmus.
• Describe the anatomical and • Describe the appearance and relevance of common
physiological mechanisms involved fundoscopic findings including vascular changes,
with the pupillary reflexes. exudates and haemorrhages.
• Demonstrate the assessment of • Discuss the relevance of colour vision assessment in
visual acuity and discuss methods of neurological examination.
correcting for refraction errors. • Demonstrate formal visual perimetry.
• Demonstrate the clinical assessment • Interpret the results of computerised visual field
of extra-ocular eye movements, testing.
visual fields and fundoscopic • Discuss the specific features of cortical blindness.
examination. • Discuss the causes of proptosis.
• Discuss the mechanism and • Demonstrate the clinical localisation of lesions
relevance of papilloedema and causing gaze palsy.
differential diagnosis.
• Discuss the relevance and
management of a spontaneous third
nerve palsy.
• Discuss the clinical features and
causes of Horner's Syndrome.
ptosis
cavernous sinus syndrome.

SYLLABUS MODULE – NEURO-OTOLOGY
• Describe in detail the anatomy of the • Interpret audiometric evaluation - pure-tone

Evaluation of external, middle and inner ear. audiometry, impedance testing, speech
• Describe the auditory pathway. discrimination, auditory brain stem evoked response
Hearing
• Demonstrate otoscopic examination (ABSER).
of the ear.
• Demonstrate the Rinne and Weber
tests.
• Discuss the examination findings and
differential diagnosis of conductive
and sensorineural hearing loss.
• Describe the anatomy of vestibular • Describe the classification of peripheral and central • Discuss common neuro-otologic disorders
Disorders of system. vestibular disorders. eg. viral labyrinthitis, viral mononeuritis,
• Interpret vestibular evaluation - benign paroxysmal positional vertigo,
Vestibular System
electronystagmography (ENG), caloric tests, rotation Meniere's syndrome, vertebrobasilar
chair testing. insufficiency, Wallenberg's syndrome.
• Discuss the differential diagnosis and the
management of dizziness.
• Discuss the differential diagnosis and management of
tinnitus.
• Describe the pathophysiology of • Discuss cholesteatoma • Describe the intracranial complications

Mastoiditis and middle ear and mastoid infections including otogenic sigmoid sinus
including acute and chronic thrombosis, extradural abscess,
Sinus Disorders
infections. cerebellar and temporal lobe abscess.

SYLLABUS MODULE – NEUROPATHOLOGY
General Pathology • Describe the normal weight of the • Describe the biochemical events of neuronal hypoxia • Describe Rosenthal fibres and their
of neurons and glia brain at different ages. resulting in cell death. significance.
• Describe the appearance of neurons, • Describe Wallerian degeneration. • Describe mechanisms of cerebral injury
astrocytes, oligodendrocytes and • Describe the function of the various types of glial associated with carbon monoxide
ependyma. cells. poisoning.
• Describe the cellular processes of • Describe the anatomical basis, structure and function • Describe the changes in the normal
repair, regeneration and recovery of of the blood brain barrier. central nervous system induced by
function. • Discuss the features of necrosis versus apoptosis in radiation.
• Describe the methods used for cell death.
neuropathological examination • Describe the reaction of glial cells to neural injury.
(tissue preparation, difference
between frozen and paraffin-
embedded sections, staining
techniques, etc) and the artefacts
that these methods produce.
Congenital • Discuss environmental influences in • Describe the detailed pathology of anencephaly, • Describe the pathology of intracranial
malformations the development of congenital encephalocele and meningocoele. birth injury and haemorrhage, and
neurological disorders. • Describe the pathology of arachnoid cysts. ischaemic lesions.
• Define the terms commonly used in • Describe the detailed pathology of Chiari • Describe the disorders of forebrain
congenital defects such as malformations including associated abnormalities. induction eg. holoprosencephaly,
porencephaly, hydranencephaly, • Describe the pathology of cerebellar malformations agenesis of corpus callosum and
microcephaly, megalocephaly, eg. agenesis, aplasia of the vermis, and Dandy anomalies of septum pellucidum.
encephalocele, meningocoele, Walker syndrome. • Describe the pathology of cerebral
holoprosencephaly, lissencephaly • Describe the pathology of craniosynostosis. heterotopias.
and spinal dysraphism. • Describe the epidemiology, embryology and • Describe in detail the CNS pathology
• Describe the classification of Chiari pathological characteristics of neural tube defects. associated with perinatal infections eg.
malformations. • Describe the following malformations of the spinal syphilis, toxoplasmosis, cytomegalovirus,
• Describe the congenital causes of cord: hydromyelia, diastematomyelia, diplomyelia, rubella and HIV.
hydrocephalus. syringomyelia and syringobulbia.
• Cerebral and spinal vascular disorders
• Describe in detail the gross and microscopic
pathology of the vascular malformations of the brain.
• Describe the histological appearances of the various

types of cerebral aneurysms.

• Describe the pathological effects of subarachnoid and
intraparenchymal haemorrhage.
• Describe the gross and microscopic pathology of
amyloid angiopathy.
• Describe the secondary pathological changes that
occur in ischaemic stroke.
• Describe the microscopic pathology of infectious and
immune mediated arteritis.
Cerebral and spinal • Discuss the common sites of • Describe the gross and microscopic
vascular disorders spontaneous intracerebral effects of radiation on normal and
haemorrhage and their likely causes. abnormal cerebral vasculature.
• Describe the pathological changes of • Describe the pathology and sequelae of
the parenchyma and cerebral thrombosis of the dural venous sinuses
vasculature associated with chronic and the deep venous system.
hypertension. • Describe the classification and detailed
• Describe the pathological differences pathology of the vascular malformations
between the various vascular of the spine.
anomalies eg. AVM, cavernoma, • Describe the pathology of Moya Moya
venous malformations, capillary disease and Takayasu's arteritis.
telangiectasia, dural arteriovenous
fistulae
• Describe the pathological
classification of cerebral aneurysms
• Describe the pathology of
atherosclerotic occlusive disease
Brain and spinal • Discuss the clinicopathological • Describe the cellular and molecular processes • Describe the pathology and
cord trauma correlates of head injury occurring after neuronal injury. pathophysiology associated with high
mechanisms eg. shear, rotation, • Describe the differences between low velocity and velocity missile injuries.
contre-coup. high velocity blunt injuries. • Describe the cellular processes of repair
• Describe the difference between • Describe the detailed gross and microscopic in the nervous system.
primary and secondary injury. pathology of diffuse axonal injury.
• Describe in detail the causes and • Discuss in detail the gross and microscopic pathology
patterns of secondary brain injury. of cerebral injury associated with raised intracranial
• Describe in detail the differences pressure.
between focal and diffuse axonal and • Describe the microscopic pathology and mechanisms
vascular injury. of formation and enlargement of chronic subdural
• Discuss the spectrum of traumatic haematomas.
intracranial haemorrhage. • Describe the gross and microscopic pathology of
• Describe the pathology of contusions acute spinal cord injury.

as it relates to the mechanism of • Describe long term pathological changes following

injury and skull anatomy. spinal cord injury.
• Describe the gross pathology of
acute and chronic subdural
haematomas.
• Describe the gross pathology of
extradural haematoma.
• Describe in detail the different types
of brain swelling.
• Discuss the mechanisms of acute
and secondary spinal cord injury.
Miscellaneous • Describe the pathological findings in • Describe the pathological features of Alzheimer's • Describe the pathological features of
nervous system the brain associated with ageing. disease. Pick's disease.
disease • Describe in detail the pathological features of • Describe the basic gross and microscopic
Parkinson's disease. pathological changes associated with
• Describe the pathological features of Huntington's peripheral neuropathies.
disease. • Describe the pathological features of
motor neurone disease.
• Describe the general pathology of
mitochondrial diseases.
• Describe the pathology of progressive
supranuclear palsy.
• Describe the pathology of the inherited
spinocerebellar degenerative diseases.
• Describe the pathology of acute
haemorrhagic leukoencephalitis.
Demyelinating • Describe demyelination and • Discuss the gross and microscopic pathological • Discuss the pathology and aetiology of
diseases classification of demyelinating findings in multiple sclerosis. central pontine myelinolysis.
disease. • Discuss the aetiological theories of
multiple sclerosis.
Skull, spine and • Describe the pathological changes in • Describe the pathology of spinal canal stenosis. • Describe the pathology of ossification of
musculoskeletal intervertebral disc degeneration. • Describe the pathology of spondylolysis and the posterior longitudinal ligament and
system • Describe the pathological process of spondylolisthesis. diffuse idiopathic skeletal hyperostosis.
osteophyte formation. • Discuss metabolic bone diseases (including renal • Describe the gross and microscopic
• Describe the pathology of osteodystrophy, primary hyperparathyroidism). pathology of fibrous dysplasia.
osteoporosis and osteomalacia. • Describe the classification of myopathies and the • Describe the gross and microscopic
• Describe the pathology of Paget's basic pathological findings. features of Paget's disease.
disease. • Describe in detail the pathology of
• Discuss the process of fracture vertebral haemangiomas.

healing. • Describe the pathology of Scheuermann's

disease and Schmorl's nodes.
Central nervous • Discuss the possible routes of • Describe the gross and histological features of a brain • Describe the pathology of prion diseases
system infections intracranial infection. abscess at various stages. and the routes of transmission.
• Discuss the normal CNS mechanisms • Describe the gross and histological features of • Describe the pathology of HIV infection of
of defence against infection. subdural empyema and epidural abscess. the nervous system.
• Describe the pathogenesis of brain • Describe the gross and microscopic features of • Describe the pathology of parasitic
abscess, subdural empyema and bacterial meningitis. infections of the CNS.
epidural abscess. • Describe the pathology of herpes simplex • Discuss the tests used to diagnose
• Discuss the stages of brain abscess encephalitis. bacterial, viral, fungal, and prion diseases
formation. • Discuss the pathology of tuberculous infections of the (including culture techniques, PCR, tests
• Describe the microbiology of CNS. for prion diseases, and EEG findings).
common cerebral infection. • Discuss the pathology of fungal infections of the CNS. • Describe the inclusion bodies found in
• Describe abnormalities (cardiac, • Describe the pathology of varicella zoster infections. various types of viral encephalitis.
pulmonary, metabolic, syndromic) • Describe the pathology of opportunistic infections in
that predispose to abscess immunocompromised patients.
formation.
• Describe the pathological features
differentiating viral, bacterial and
fungal CNS infections.
• Discuss the systemic effects
associated with meningitis and
encephalitis eg. Skin lesions in
meningococcal infection.
Immunopathological • Describe the pathology of • Describe the pathology of Guillain-Barre syndrome. • Describe the pathology of immune-
disorders myasthenia gravis. • Describe the pathology of sarcoidosis and its mediated vasculitis.
• Describe the pathological features in neurological manifestations.
rheumatoid arthritis with particular
respect to vertebral column.
• Describe in general terms the
neuropathology of autoimmune
diseases such as systemic lupus
erythematosis.
Toxic and deficiency • Discuss the neurological and • Describe the neurological effects of vitamin A • Discuss the effects of metal toxicities
disorders pathological effects of alcohol intoxication. (e.g. lead, aluminium, mercury).
intoxication and withdrawal and its • Discuss the pathological changes associated with
implications with management. chronic phenytoin use.
• Describe the neuropathology of
chronic alcoholism including

Wernicke-Korsakoff syndrome.
• Discuss the neuropathological effects
of vitamin deficiencies e.g. A, B1,
B12.
• Describe the effects of protein and
caloric deficiency, especially in the
setting of trauma.
Brain shifts and • Describe the stages of compensation • Discuss the pathophysiology of upward trans-tentorial • Discuss the pathological effects of rapid
herniation for a space-occupying lesion. herniation. reduction of intracranial pressure with
• Describe the pathology of trans- treatment of herniation syndromes,
tentorial herniation. including brain swelling and reperfusion
• Describe the pathology of tonsillar injury.
herniation.
• Describe the pathophysiology of
herniation after lumbar puncture.
• Describe the pathology of subfalcine
herniation.
• Describe the pathology of brain
herniation through a skull defect.
• Describe the secondary effects of
brain herniation: vascular
compression, false-localising signs.
• Describe Kernohan's notch.
• Discuss the differences between
slowly- and rapidly-expanding
lesions.
Neuro-oncology • Discuss the general molecular • Describe the histopathological features of scalp and • Discuss the theories of oedema
changes in neoplastic cells. skull tumours. pathogenesis within the brain
• Discuss the method of growth and • Describe factors secreted by tumours which modulate adjacent to extra-axial tumours.
spread of intrinsic tumours. the immune response and cause immunodeficiency • Describe common immunological
• Differentiate between intrinsic and and the mechanisms by which they do this. deficits in patients treated for
extrinsic tumours on gross • Describe commonly used histopathological markers of neurological tumours.
specimens. cell kinetics and their significance. • Describe current theories
• List the classification of tumours that • Describe the immune deficiency syndromes in relation concerning apoptosis and necrosis.
occur at the skull vault and scalp. to neurological tumours. • Describe in detail current WHO
• Describe the nature of cell division • Outline the current WHO system for brain tumour classification for neurological
and the cell cycle. classification. tumours.
• Describe the abnormalities of the cell • Identify on pathological slides the features on which • Describe common XRT-induced
cycle commonly identified in classification of tumour type and tumour grade are brain tumours - epidemiology,
neoplasia. based - particularly for common tumours including pathology and investigation.

• Define terms "benign", "neoplastic" gliomas, meningiomas, metastases, pineal region • Identify the macroscopic and
and "malignant" as relevant to tumours, acoustic neuroma, pituitary tumours and microscopic differences between
neurological tumours. craniopharyngioma. neurofibromas and schwannomas.
• Define "tumour suppressor gene", • Describe in detail the pathology of the • Identify the common histological
"oncogene", "loss of heterozygosity", neurophakomatoses. features used to classify gliomas
"growth factor", "growth factor • Describe the gross and histopathological features of such as "gemistocyte", "necrosis",
receptor", and "cytokine". List gliomas. "mitosis", "anaplasia", "endothelial
examples of each under current • Describe the gross and histopathological features of hyperplasia", "Rosenthal fibres",
investigation and explain their intraventricular tumours. "pilocytes", "palisading", "rosettes"
significance to common CNS • Describe the distinguishing features of fourth and "pseudorosettes".
neoplasms. ventricular tumours including medulloblastoma and • Discuss controversies in tumour
• Define tumour invasion and ependymoma. classification and review the
angiogenesis and describe the • Describe the distinguishing features of third literature of those encountered in
underlying mechanisms. Discuss the ventricular tumours including colloid cysts. clinical practice.
significance of each to tumour • Describe the distinguishing features of lateral • Describe the risks of developing a
progression for common CNS ventricular tumours including meningioma and CNS tumour based on
neoplasms. choroid plexus tumours. environmental or medical
• Define "tumour markers" and their • Describe the gross and histopathological features of exposure to viruses, chemical or
use in clinical practice. cerebral metastases. radiation.
• Describe elements of immune • Describe primary brain tumours that metastasise to • Describe biochemistry and
system and immune response to CSF and extraneural pathways involved. function of neurofibromatosis I
brain tumours. • Describe macroscopic and histological features of protein (neurofibroma) and
• Define "cytokine", "autocrine' and meningiomas. Neurofibromatosis I protein
"paracrine". • Identify the macroscopic and microscopic features of (schwannoma/merlin).
• Describe the history of brain tumour epidermoid, dermoid and teratoma. • Describe the pathological features
classification systems. • Differentiate mature, immature and malignant of uncommon tumours of the
• Describe different systems for teratoma. meninges, including lipoma,
classification of astrocytomas. • Describe the classification of germ cell tumours and angiolipoma, hibernoma,
• Discuss the use of tumour grade tumour markers associated with these. fibrosarcoma, fibromatoses,
within the classification. • Describe the gross and microscopic features of fibrous histiocytoma, tumours of
• Describe the multistep nature of schwannoma. muscle and cartilaginous origin,
tumour pathogenesis in general • Descriie the gross and microscopic features of haemangioma, angiosarcoma,
terms. haemangioblastoma. epithelioid
• Describe the basis of general • Describe the gross and microscopic features of haemangioendothelioma, Kaposi
tumourigenesis by viruses, pituitary region tumours. sarcoma, melanocytoma,
chemicals and radiation. • Describe the gross and microscopic pathological melanocytosis and malignant
• List the conditions known as features of chordoma. melanoma.
neurophakomatoses. • List the tumours that may arise in the orbit.
• Define the term glioma. • Describe the gross and microscopic pathological
• List the tumours that may appear features of tumours which may appear in the orbit.
within the ventricular system by • Describe the gross and microscopic pathological
location. features of cerebral lymphoma and the current WHO

• List the tumours that tend to classification.

metastasize to the central nervous • Discuss the pathology of CNS lipomas.
system with particular reference to • Describe the gross and microscopic pathological
age and gender. features of spinal tumours.
• Describe current theories of
metastatic spread of tumours to the
central nervous system.
• Describe current WHO classification
of meningiomas.
• Describe the common intracranial
locations of meningioma.
• Define the cell of origin and
cytogenetics of meningioma and
theories of tumourigenesis.
• Define and differentiate epidermoid,
dermoid and teratoma.
• Describe common locations of
epidermoid and dermoid and the
epidemiology of both.
• Describe the classification of pineal
region tumours including WHO.
• Describe the classification and
pathology of pineal region tumours.
• List the tumours that may arise in
the cerebellopontine angle (CPA).
• Discuss the association of vestibular
schwannoma with other disorders,
including NF-2 and the underlying
genetic abnormalities.
• Describe the classification of
pituitary tumours with respect to the
cell of origin and size.
• Discuss the embryogenesis of
chordoma.
• Discuss the classifications of
lymphoma.
• Discuss the relationship between
lymphoma and associated conditions
e.g. immunosuppression.
• Describe the common locations in
which intracerebral and intraspinal
lipomas occur, their anatomical

relationships and relative frequency

and embryological origin and
development
• List the tumours that tend to
metastasize to the spine with
particular reference to age, gender
and frequency.
• Classify the common extradural,
intradural (extramedullary) and
intramedullary tumours.
SYLLABUS MODULE – NEUROPHARMOCOLOGY AND NEUROCHEMISTRY
Blood brain barrier • Discuss the relevance of the blood • Discuss the various interventions that
brain barrier to central nervous have been used to alter the blood-brain
system drug delivery. barrier for drug delivery.
Steroids • Describe the basic steroid ring and • Discuss why dexamethasone is most commonly used • Discuss the evidence for glucocorticoid
its modifications to produce the in neurosurgery. use in cerebral protection.
various subgroups. • Describe the mechanism of action of glucocorticoids • Discuss the evidence for glucocorticoid
• Discuss the actions of the steroid on various types of cerebral oedema. use in neurotrauma.
subgroups. • Discuss the role of steroids in the
• Discuss the pharmacodynamics of prevention of lipid peroxidation.
dexamethasone, prednisone and
hydrocortisone.
• Discuss the side-effects of steroids
commonly used in neurosurgery
practice.
• Discuss iatrogenic suppression of the
adrenal cortex and its management.
Anticonvulsants • Classify the anticonvulsant • Compare and contrast the indications and limitations • Discuss the role of anticonvulsants in pain
medications based on their of phenytoin, sodium valproate and carbamazepine. management.
mechanism of action. • Discuss the evidence for the use of prophylactic • Discuss the use of anticonvulsants in
• Describe in detail the pharmacology anticonvulsants in trauma, elective craniotomy and pregnancy.
of phenytoin, sodium valproate, aneurysmal subarachnoid haemorrhage.
carbamazepine and gabapentin.

• Discuss the role of serum level

monitoring in long-term
anticonvulsant therapy
administration.
• Define status epilepticus and discuss
in detail its management.
• Discuss the effect of
benzodiazepines on seizure activity.
Calcium channel • Discuss the mode of action and side- • Discuss the evidence for the use of calcium channel • Discuss the evidence for the use of
blockers effects of the groups of calcium blockers in the management of cerebral vasospasm. calcium channel blockers in the
channel blockers. management of neurotrauma.
• Describe the administration of
nimodipine.
Mannitol and • Discuss in general terms the • Discuss the role of mannitol in neurosurgery practice. • Discuss the role of mannitol in cerebral
diuretics pharmacology and clinical use of • Describe the potential negative effects of recurrent protection.
diuretics. and prolonged mannitol use. • Discuss the role of urea in the
• Describe in detail the pharmacology • Compare and contrast the use of the various types of management of raised intracranial
of mannitol. diuretics fro reducing raised intracranial pressure. pressure.
• Describe the indications for mannitol • Discuss the effect of mannitol on the microcirculation.
use in acute head injury.
Barbiturates • Describe the pharmacology of the • Discuss the use of barbiturates in epilepsy • Discuss the role of barbiturate therapy in
barbiturates. management neuroprotection
• Describe the effect of the • Describe the effects of barbiturates on
barbiturates on neuronal function intracranial and cerebral perfusion
pressures.
Antibiotics • Describe the classes of antibiotics • Discuss the evidence for prophylactic antibiotic • Discuss the use of antiviral agents in
commonly used in neurosurgery. therapy in operative neurosurgery. neurological disorders.
• Describe the mode of action of the • Discuss the role of prophylactic antibiotic therapy in
commonly used antibiotics. cerebrospinal fluid leak and drains.
• Discuss the bioavailability of • Discuss the use of topical antibiotics in neurosurgery.
antibiotics in the central nervous • Discuss the serum monitoring of antibiotics.
system. • Discuss the use of antibiotics in the presence of
• Discuss the use of antibacterial skin known allergy.
preparations in neurosurgery.
Analgesics • Describe the classes of analgesics • Describe the relative efficacy of the analgesics
commonly used in neurosurgery commonly used in neurosurgery
• Describe in detail the pharmacology • Discuss the pharmacology of opiate dependence

of paracetamol and aspirin

• Describe in detail the pharmacology
of the opiates
• Describe the pharmacology of the
non-steroidal anti-inflammatory
medications
Other • Describe the management of acute • Discuss the evidence for pharmacological deep • Discuss the clinical application of
anaphylaxis. venous thrombosis prophylaxis. ionotropes.
• Discuss the drug interactions of • Discuss the uses of benzodiazepines in neurosurgery. • Discuss the use of anti-platelet and anti-
warfarin. • Discuss the uses of the anti-depressants in coagulant therapies following cerebral
• Describe the options for therapeutic neurosurgery. ischaemia.
anticoagulation. • Discuss, in general terms, the pharmacology of the
• Describe the options for reversal of ionotropes.
anticoagulation. • Discuss the pharmacological management of acute
• Discuss the pharmacology of the hypertension in neurosurgery
anti-platelet agents.
• Discuss, in general terms, the
pharmacology of the
benzodiazepines.
• Discuss, in general terms, the
pharmacology of the anti-
depressants commonly encountered
in neurosurgery.
• Discuss the pharmacology of the
commonly used anti-emetic drugs.
• Discuss, in general terms, the basic
pharmacology of the commonly used
local anaesthetic drugs.
• Discuss the pharmacology of the
medications used for peptic ulcer
prophylaxis.
• Discuss the basic pharmacology of
the major tranquillisers used in
neurosurgery.

SYLLABUS MODULE – NEUROPHYSIOLOGY
Fluid and electrolyte • Demonstrate the clinical assessment • Describe the composition and uses of colloid • Discuss cerebral salt wasting syndrome.
balance of hydration status. solutions. • Discuss the role of the pituitary and
• Define the clinical syndrome of • Discuss the causes, clinical features and management hypothalamus in fluid and electrolyte
shock. of hyponatraemia. homeostasis.
• Discuss the various types of shock • Discuss central pontine myelinosis, its causes and
and their management. avoidance.
• Define the normal electrolyte • Describe in detail the causes and management of
concentrations. diabetes insipidus.
• Describe the major intracellular and • Describe the clinical syndromes associated with hypo
extracellular ions. and hyper calcaemia, including causes and
• Describe the sodium potassium management.
pump and calcium channels.
• Calculate total body water deficit /
excess.
• Define and calculate the anion gap
and discuss its relevance.
• Define the normal fluid and
electrolyte replacement.
• Define the composition of normal
saline, Hartman's solution, Ringer's
solution and commonly used
dextrose intravenous solutions.
Acid base balance • Differentiate respiratory and

metabolic acidosis and alkalosis on
blood gas analysis.
• Discuss the management of
metabolic acidosis and alkalosis.
Respiratory function • Define normal blood gases. • Describe in physiological terms the cardio pulmonary • Discuss the effects of mechanical
• Discuss the uses and limitations of changes associated with pulmonary embolism. ventilation on intracranial pressure.
oxygen saturation monitoring. • Describe the diagnostic features of pulmonary
• Demonstrate the assessment and embolism.
management of an adequate airway. • Discuss the indications and uses of bicarbonate

• Define normal respiratory function therapy.

test parameters.
• Discuss V/Q mismatch.
• Describe in detail the effects of blood
gas derangement on cerebral blood
flow.
• Define the terms positive pressure
ventilation, PEEP, CPAP, BiPAP and
assisted/controlled ventilation, and
discuss their clinical uses.
Principles of • Define the normal caloric • Discuss neurological disorders associated with vitamin •
nutrition requirements. deficiencies.
• Discuss the altered nutritional •
requirements in neurological disease
states eg. Trauma
•
Energy metabolism • Define both aerobic and anaerobic • Define the term CMRO 2 • Define the therapeutic strategies for
in the brain pathways for energy production in • Discuss regional variations in cerebral energy alteration of neuronal CMRO 2.
the central nervous system. metabolism.
Cerebral blood flow • Describe normal cerebral blood flow • Describe the methods for measurement
and oxygen consumption. of regional cerebral blood flow and its
• Define cerebral perfusion pressure clinical application.
• Describe in detail the autoregulation
of cerebral blood flow.
Cerebrospinal fluid • Define the normal contents of the • Define the mechanisms for transmission of altered • Discuss the concepts of
and intracranial cranium. intrathoracic and intraabdominal pressure to the CNS. compartmentalisation with respect to ICP.
pressure • Discuss the Monro-Kellie doctrine.
• Define normal intracranial pressure
and physiological factors affecting it.
• Define normal ICP wave form and
discuss its components.
• Define the normal processes of
cerebrospinal fluid production,
circulation and absorption.
• Define the normal composition of
cerebrospinal fluid.
• Define normal cerebrospinal fluid
pressures.

Neural conduction • Define the resting potential of • Discuss the factors affecting normal axonal • Discuss the physiological control of
and muscle normal axonal membrane and the conduction rate. normal sexual function.
contraction mechanisms of its maintenance. • List the normal excitatory and inhibitory
• Describe a normal action potential. neurotransmitters in the CNS.
• Discuss the role of myelin in action • Discuss the physiological basis for the different
potential transmission. somatic sensory modalities including specific
• Classify peripheral nerve fibres receptors and conduction pathways.
based on size and function. • Discuss the physiological control of normal bladder
• Define the neurotransmitters at the and bowel function.
neuromuscular junction.
• Define the physiology of smooth and
striated muscle contraction.
• Define the monosynaptic spinal
reflex arc.
• Discuss the physiological factors
affecting muscle tone.
• Describe the more complex reflex
arc.
• Discuss the physiological effects of
parasympathetic nervous system.
• Discuss the physiological effects of
sympathetic nervous system.
• Define the neurotransmitters in the
autonomic nervous system.
Consciousness • Discuss the factors affecting • Describe the function of the reticular activating
consciousness. system.
• Define the normal sleep patterns.
•
Special senses and • Describe the physiology of the • Discuss the physiology of posture maintenance and
other perception of light and colour. balance.
• Describe the mechanisms of visual • Discussion the function of bulbar reflexes.
accommodation. • Describe the physiology of pain perception and
• Describe the physiology of taste and modulation.
smell sensation.
• Describe the physiology of hearing.
Neuroendocrine • Describe in detail the hypothalamic • Discuss the functions of the pineal gland.
pituitary axis.
• List the hormones released by the
pituitary and the functions on the

end organs.
• Discuss the diurnal variation in
hormone production.
• Describe the hypothalamic and
pituitary regulation of the
reproductive cycle.
• Describe the regulation of adrenal
function.
SYLLABUS MODULE – NEURORADIOLOGY
• Discuss the indications and • Discuss the plain Xray features associated with raised • Identify normal anatomical variations in
Plain Xrays of the limitations of plain radiography. intracranial pressure. complex pathological conditions
• Identify the important bony • Discuss the features of the sella turcica on plain skull identifiable on plain radiology, including
Skull and Spine
landmarks in plain Xrays of the skull Xray and its relevance to neurosurgery. differential diagnosis.
and spine. • Describe the application of intraoperative
• Discuss the indications for spinal image intensification eg spinal surgery
Xrays following trauma. and needle placement for trigeminal
• Describe the views of plain cervical rhizotomy.
spine and lumbar spine series and
identify the normal anatomy.
• Identify the radiological features of
common spinal fractures and
common spinal disorders.
• Discuss the radiological
determination of spinal stability
following trauma.
• Demonstrate a working knowledge
of an image intensifier and basic
radiation safety involved in its use.
• Describe in detail the physics and • • Demonstrate the manipulation of CT

CT Scanning principles of CT scanning. • Describe the levels and window settings for CT images to obtain data for frame based
• Discuss the development and scanning and how they can be manipulated to gain and frameless stereotaxy.
evolution of CT scanning systems. maximum information. • Demonstrate the ability to accurately
• Discuss the role of Hounsefield in • Discuss the principles of image manipulation, 3D interpret radiological examinations of
radiology and define the Hounsefield reconstruction and CT angiography. neurosurgical patients.

Unit. • Identify spinal traumatic injuries of the cervical, • Critically appraise latest developments in
• Describe current CT scanning thoracic and lumbar spines in CT scans, including the technology of CT scanning.
technology eg helical scanning, vertebral body fractures (and subtypes) facet • Discuss the application of CT angiography
multislice scanning. fractures and dislocations, posterior element and compare it with conventional and
• Identify the detailed anatomy of a fractures, vertebral subluxation/dislocation. magnetic resonance angiography.
normal cranial CT scan. • Describe radiological findings of traumatic
• Describe the indications for cranial craniovertebral junction, atlantoaxial and subaxial
CT following head injury. injuries.
• Describe the indications for CT scan
of the spine following trauma.
• On abnormal CT scans, identify the
following:
• skull fractures
• intracranial haematomas
• subarachnoid haemorrhage
• ischaemic and venous infarction
• tumours and cysts
• hydrocephalus
• Discuss the uses, indications and
risks of contrast agents in CT
scanning
• Describe the underlying principles of • Discuss the risks and limitations of MR scan in • Describe how pulse sequences are
MRI MRI. patients with aneurysm clips. combined to produce effective and
• Demonstrate the ability to identify • Discuss spatial inaccuracies in MR scanning and its efficient imaging protocols for common
normal anatomical structures on effect of stereotaxy. disease processes.
MRI. • Discuss the use and limitations of MRI in head and • Discuss the applications of spin echo,
• Discuss the conditions for which MRI spinal trauma. gradient echo, inversion recovery,
is superior to CT imaging. • Demonstrate the ability to recognize detailed neuro- chemical shift imaging, suppression
• Discuss the conditions for which MRI anatomy as shown by MRI. techniques, high-speed imaging, and
is inferior to CT imaging. • Describe MRI appearance of spinal ligament injury, evolving sequences.
• Discuss the risks and limitations of traumatic disc herniation, spinal cord contusion and • Identify degenerative spinal conditions on
MRI. spinal epidural haematoma. MRI, including disc degeneration, disc
• Discuss the types and use of • Use MRI imaging findings to differentiate different herniation, degenerative spinal stenosis,
contrast in MRI. types of focal intracranial lesions (neoplastic, facet hypertrophy, osteophyte formation,
• Describe commonly used pulse inflammatory, vascular) based on anatomic location foraminal stenosis, spondylolisthesis, and
sequences and standard MR (e.g. intra- vs. extra-axial), contour, intensity and ossification of posterior longitudinal
protocols. enhancement pattern. ligament.
• Identify the following pathological • Identify and differentiate on MRI diffuse intracranial • Discuss the uses and limitations of
conditions shown on MRI: abnormalities (e.g. hydrocephalus and atrophy). diffusion/perfusion MRI, functional MRI
• Infarction • Identify treatment-related findings on MRI (e.g. post- and MR spectroscopy.
• intracranial haemorrhages surgical and post-radiation). • Demonstrate the use of CT and MRI

• infections sequences in image guided surgery.

• tumours • Discuss the application of MR
• cysts angiography and compare it with
• congenital abnormalities conventional and CT angiography.
• Identify the signal characteristics of
intracranial haemorrhage of different
ages on MR scans.
• Discuss the specific contraindications
to a patient having MR scan.
• Describe the evolution of • Identify uncommon vascular anatomical variations on • Identify normal and abnormal spinal
Cerebral and Spinal angiographic techniques. angiography. vascular anatomy on angiography.
• Describe the principles underlying • Identify anterior and posterior circulation aneurysms
Angiography
equipment used for angiography e.g. and other vascular anomalies.
Digital Subtraction Angiography.
• Discuss the use of current
angiographic techniques.
• Describe detailed cerebral vascular
anatomy on angiography.
• Demonstrate a detailed
understanding of the current
indications, limitations and risks of
angiography. For example, be able
to identify all relevant extra- and
intra-cranial arteries (secondary and
tertiary branches of the carotid and
basilar arteries) and veins (cortical
and deep cerebral veins) on
angiography.
• Discuss the interventional • Discuss the radiological equipment facilitating • Critically evaluate the use of
Interventional techniques available in interventional techniques e.g. 3D versus biplanar interventional neuroradiology as an
neuroradiology. versus uniplanar imaging. adjunct to conventional surgery.
Neuroradiology
• Describe the indications, risks and benefits for • Discuss in detail current indications of
neurointerventional procedures including this modality for treatment of aneurysms,
embolization, angioplasty and stenting. vasospasm, cranial and spinal vascular
• Discuss different types of available endovascular coils malformations, tumour embolization,
and their uses. carotid and vertebral stenosis, carotid
• Discuss the uses and limitations of balloon technology and vertebral dissection.
in interventional radiology. • Discuss the endovascular management of
• Discuss the uses, risks and limitations of stents in dural malformations and
interventional radiology. caroticocavernous fistulae.

• Discuss the uses, risks and limitations of glues, • Compare and contrast surgical and
particles and other embolic material in interventional endovascular treatment of intracranial
radiology. aneurysms.
• Discuss the role of embolization and
endovascular techniques in the
management of AVMs.
• Discuss the role of embolization and
endovascular techniques in the
management of intracranial and spinal
tumours.
• Discuss the basic chemical • Discuss confounding factors influencing the use of
Radiographic properties of radiographic contrast contrast agents in radiology (e.g. renal function, age
agents currently used for and iodine allergies).
Contrast Agents
angiography, myelography, CT and
MRI.
• List the most commonly used
contrast agents and discuss the
properties of each. eg. Non ionic
iodinated contrast media.
Gadolinium.
• Describe the features and
management of contrast reaction.
• List the indications, contra
indications and risks of contrast
agents.
• Describe the principles of • Describe the neurological applications of ultrasound • Describe the technique and the uses and
Ultrasound and ultrasound, Doppler, how it works, (for example its use in neonates and intra-operative limitations of a transcranial Doppler.
and its limitations. ultrasound).
Doppler
• Discuss the historical uses and • Identify normal and pathological findings on •
Subarachnoid application of ventriculography. myelography.
• Discuss the current application
Contrast Agents
indications and risks of myelography
and cisternography.

SYLLABUS MODULE – NUCLEAR MEDICINE
Radionuclide • Discuss the various • Discuss the use of radionuclide cisternography in the • Discuss this technique in evaluating lung
Imaging radiopharmaceuticals available and diagnosis of normal pressure hydrocephalus and function, particularly as this applies to
list those most commonly used eg. identification of cerebrospinal fluid (CSF) leaks. (In- pulmonary embolus. For example, use of
Technecium-99m- 111-DTPA). inhaled Xe-133 and intravenous Tc-99m-
hexamethylpropyleneamineoxime • PET scanning; SPECT scan MAA.
(Tc-99m-HMPAO), Tc-99m-ECD, Tc- • Discuss the history and the principles of Positron •
99m-DTPA. Emission Tomography. Describe the
• Describe the function of the gamma radiopharmaceuticals used in this technique, for
camera. example FDG (fluorodeoxyglucose)
• • Describe the function of a cyclotron and how this
contributes to the clinical uses of PET scanning.
• Discuss the clinical application of nuclear bone scans.
•
PET scanning; • Describe the principle of Single • • Discuss the clinical applications of PET
SPECT scan Photon Emission Computered scanning, together with advantages,
Tomography. limitations and cost.
• Discuss the radio pharmaceuticals •
used and understand the clinical
indications, uses and limitations of
this technique.
SYLLABUS MODULE – OPERATIVE NEUROSURGERY
Surgical ligatures, • Describe different types of suture • Discuss the origins, applications and limitations of • Demonstrate rapid, precise and dexterous
knots, stapling materials, their uses, advantages different types of tissue glues. suture and knot tying techniques by all
devices and tissue and disadvantages. • Demonstrate cosmetic repair of facial wounds. methods (hand and instrument ties).
• Describe different surgical needle
glues
profiles, their uses, advantages and
disadvantages.
• Demonstrate different types of

suturing techniques, including

interrupted and continuous, simple,
mattress and subcuticular.
• Demonstrate dexterity with use of
needle holders, forceps and standard
surgical instruments, and detailed
understanding of their appropriate
applications.
• Demonstrate hand-ties and
instrument ties of sutures in
dextrous manner and describe the
applications of each.
• Demonstrate use of skin staples.
• Demonstrate use of basic micro-
dissection instruments, including
micro-suction, scissors and
bayonette instruments.
• Demonstrate careful and atraumatic
tissue-handling techniques.
• Expertly perform wound
debridement, wound closure in
layers and routine layered closure of
standard cranial and peripheral
surgical exposures.
Haemostasis in • Describe the physiological processes • Describe haemostatic techniques previously used • Demonstrate competency in obtaining
neurosurgery involved in clotting, including the commonly in neurosurgery, such as muscle stamps effective and safe haemostasis in cranial
intrinsic and extrinsic coagulation and hydrogen peroxide, and their application to and spinal surgery.
cascades, platelet and endothelial modern neurosurgery. • Describe techniques available for
factors. • Discuss techniques for definitive control of bleeding haemostasis following injury to major
• Describe the composition, from a venous sinus. intracranial arteries.
mechanism of action, advantages • Demonstrate effective haemostatic techniques as • Describe considerations relating to
and disadvantages of common applicable to surgery for head injuries and intracranial sacrifice of intracranial veins and venous
neurosurgical haemostatic agents haematoma. sinuses.
including oxidised cellulose, fibrillary • Describe the types and applicability of wound drains
collagen, gelatin sponge, and topical to neurosurgical practice, their management, risks
thrombin. and complication avoidance.
• Define the haematological
parameters of normal coagulation,
and the acceptable range of these
parameters for the safe performance
of intracranial neurosurgery.

• Describe the factors which may

predispose a patient to coagulopathy
and the investigation and
management of this.
• Describe the investigation of
abnormal haemostasis.
• Describe the effects of common
medications (including aspirin, low-
dose heparin, low-molecular weight
heparin, and warfarin) on
haemostasis, investigation for these
effects and management of
coagulopathy due to these
medications.
Thrombo-embolic • Discuss the management of a • Describe potential alternatives to anticoagulation for • Discuss appropriate prophylactic and
prophylaxis patient with pulmonary embolism management of major venous thromboembolism. therapeutic measures for arterial
after craniotomy. • Discuss appropriate management of DVT with no thromboembolism during and after
• Describe risks and benefits of types embolic complications following neurosurgery. intracranial interventional radiological
of anticoagulation for thrombo- procedures, such and aneurysm coiling,
embolic complications following angioplasty and stenting, and
surgery. thrombolysis of intra-arterial thrombo-
• Discuss in detail the various embolism.
methods (including drugs and
mechanical devices, physiological
manipulations) of thrombo-embolic
prophylaxis available and their
applicability to neurosurgical
practice.
• Identify neurosurgical conditions and
individual patient factors which pre-
dispose to thrombo-embolism, and
recommend appropriate prophylaxis.
• Identify the clinical features
suggestive of thrombo-embolic
complications, and perform
appropriate investigation and
management.
• Describe in detail reversal of the
effects of different types of
anticoagulants and anti platelets
agents in both emergency and

elective situations.
Tracheostomy • Discuss the indications for a • Compare and contrast techniques of percutaneous • Demonstrate an open surgical
tracheostomy. and open tracheostomy. tracheostomy.
• Describe the routine nursing • Describe in detail the technique of open • Demonstrate alternative methods to
management of a patient with tracheostomy. control bleeding from a large thyroid
tracheostomy. • Describe the assessment of a patient for removal of isthmus during tracheostomy.
• Describe the common available tracheostomy. • Discuss the alternative methods of
types of tracheostomy tubes, opening the trachea for tracheostomy and
including cuffed and uncuffed, the advantages and disadvantages of
fenestrated and removable inner each method.
tube. Describe the uses, limitations • Discuss particular considerations for
and risks associated with each type. tracheostomy relating to paediatric
• Demonstrate the management of a patients.
patient in respiratory distress • Perform an open surgical tracheostomy.
possibly due to occluded • Perform alternative methods to control
tracheostomy tube. bleeding from a large thyroid isthmus
• Demonstrate a detailed knowledge during tracheostomy.
of the cervical anatomy as pertaining
to tracheostomy.
Approaches to • Demonstrate the foramen of Monro and

intraventricular landmarks in the lateral and 3rd
lesions ventricles with a ventriculoscope.
•
Approaches to the • Demonstrate the exposure of the cranial
brainstem nerve attachments to the pons and
medulla.
• Describe the removal of a brain stem
cavernoma.
Infection avoidance • Discuss in detail the methods of • Discuss the role of prophylactic antibiotics in • Discuss evidence for and against shaving
in neurosurgery infection avoidance in neurosurgery. neurosurgery, evidence for their effectiveness, and the scalp for intracranial surgery.
• Demonstrate uncompromising sterile risks associated with their use.
technique in the operating room and • Discuss the role of patient health (including
during bedside procedures. compromised states), drugs, radiotherapy and
• Discuss the aseptic management of implants on the risk of surgical infection, and
CSF drains in the neurosurgical appropriate prophylactic measures
ward. • Compare and contrast different types of skin
• Describe the CSF parameters antiseptic preparation for neurosurgical procedures.
indicative of meningitis following a • Discuss the evidence for the use of occlusive incise
neurosurgical procedure. drapes.

Approaches to • Describe the anatomy of the anterior • Demonstrate proficient closure of thoracic/abdominal
abdominal and abdominal wall and the chest wall wall, for example, following VP shunt insertion or
thoracic cavities with particular reference to the thoracotomy.
layers encountered and relations of • Discuss advantages and disadvantages of different
vital structures encountered during types of approaches to plural and peritoneal cavity.
access to these cavities. •
• Describe appropriate methods of
layered closure of abdominal and
thoracic cavities, including use of
drains and suture types/techniques.
History of • Discuss neurosurgery in antiquity. • Discuss the contributions of Yasargil and Drake to the • Discuss specific published neurosurgical
neurosurgery • Demonstrate appreciation of development of microsurgical technique. anatomy papers (e.g. the work of
contributions of surgeons at the turn Rhoton).
of the 20th century to neurosurgery, • Discuss the history of peripheral nerve
such as MacEwan and Horsely. surgery.
• Discuss the contributions of Cushing
and Dandy to the development of
neurosurgery.
Patient positioning • Discuss in detail the devices and • Position a patient in the lateral position for posterior
in neurosurgery techniques for stabilising and holding fossa surgery.
the head during intracranial • Discuss positioning options for surgery in the
neurosurgery and their relevance to posterior fossa, including advantages and
different procedures and positions. disadvantages.
• Demonstrate proficient and safe use • Compare and contrast lateral and prone positions for
of the Mayfield 3-point head clamp posterior spinal surgery and position patients in these
or similar devices. positions.
• Describe in detail risks associated • Discuss the risks and complication avoidance
with skull-fixation devices during associated with the sitting position.
surgery, safe and appropriate pin • Demonstrate the appropriate selection and use of
placement and risks associated with cushions and frames for positioning in the prone
its use. position for a variety of spinal procedures.
• Position a patient for burr-hole •
ventriculostomy.
• Demonstrate safe and appropriate
padding of pressure points and
peripheral nerves for neurosurgical
cases in the supine, prone and
lateral positions.
• Demonstrate rapid and safe

positioning of the patient for large

trauma craniotomy, including
protecting the cervical spine during
intubation and positioning.
• Demonstrate the positioning of a
patient for a pterional craniotomy.
• Discuss appropriate care of the eyes
and ears during intracranial surgery.
Principles of micro • Describe the design advantages and • Discuss the uses of sharp and blunt dissection • Demonstrate dexterity of use of
neurosurgery use of bayonette instruments. techniques in the subarachnoid spaces with particular microscopic dissection instruments under
• Describe the advantages and reference to the descriptions of Yasargil. the operating microscope (eg splitting
disadvantages of the various types • Demonstrate dexterity with use and selection of basic Sylvian fissure).
of magnification and illumination. microsurgical instruments. • Discuss the principles of aneurysm
• Discuss the principles and techniques of microsurgical clipping, including the use of temporary
anastomotic techniques. clipping and the selection and use of
• Describe in detail techniques available to minimise various clips including fenestrated clips.
brain retraction during microsurgical dissection. • Demonstrate competence in microscopic
• Describe in detail exposure and dissection techniques dissection technique in elective spinal
as applied to all anterior circulation aneurysms. procedures such and lumbar
microdiscectomy and anterior cervical
discectomy.
• Discuss in detail complex microsurgical
approaches including highly selective
amygdalohippocampectomy, exposure
and clipping techniques for posterior
circulation aneurysms, microvascular
anastomotic procedures.
• Demonstrate microscopic suture
techniques of dural closure under
operating microscope.
•
Surface anatomy • Demonstrate the surface anatomy of • Define the surface anatomy of the vertebral levels • Describe the relations of the foramen
the sylvian fissures, central sulcus, according to landmarks on the anterior aspect of the magnum, and demonstrate a cisternal
and the occipitoparietal sulcus. neck. puncture.
• Identify the surface anatomy of the • Define the vertebra prominens and describe its • Demonstrate surface representation on
transverse and sigmoid sinuses accuracy in assessment of vertebral levels. the scalp of lesions identified on CT and
• Identify the surface anatomy of the • Define the surface anatomy of the thoracic vertebra MRI, their relationship to eloquent brain,
sensorimotor cortex and Wernicke's relative to the sternum. and perform appropriately placed
and Broca's areas. • Describe the surface anatomy of the cervical carotid craniotomy.
• Define the pterion and identify its artery and the level of the bifurcation. • Perform the appropriately placed
surface anatomy. • Describe the surface anatomy of the internal jugular craniotomy and dural opening for a

• Define the surface anatomy of the and subclavian veins, their relationships to adjacent transcallosal approach to the third
lumbar vertebrae and of the conus structures, and be able to demonstrate the safe ventricle, with particular reference to the
medullaris. insertion of central venous catheter into both of these surface anatomy and venous anatomy.
• Demonstrate a safe diagnostic veins. • Perform the appropriately placed
lumbar puncture. • Describe the surface anatomy of the thoracic cavity, craniotomy and dural opening for
• Demonstrate the surface anatomy of including the diaphragm and internal mammary microvascular decompression of the fifth
the carpal tunnel and the neural and arteries. nerve, with particular reference to the
vascular structures at the wrist. • Demonstrate safe insertion of an intercostal catheter surface anatomy and venous anatomy.
• Describe the surface anatomy of the and discuss placement options for drainage of
major peripheral nerves, including haemothorax and pneumothorax.
median, ulnar, radial, sciatic, medial • Demonstrate the safe insertion of a lumbar drain
and lateral popliteal (common using surface landmarks.
peroneal), femoral, saphenous and • Describe the vascular and neural supply of the scalp,
sural nerves. and discuss their importance in relationship to various
• Demonstrate the cutaneous scalp incisions used for craniotomy.
distribution of the sensory
distribution of the major peripheral
nerves, including median, ulnar,
radial, sciatic, medial and lateral
popliteal (common peroneal),
femoral, saphenous and sural nerves
and perform a full clinical
examination of these nerves.
• Demonstrate the dermatomes and
the cutaneous sensory distribution of
the cranial nerves.
• Demonstrate the traditional points
for diagnostic burr-holes used in
trauma patients prior to scanning
availability.
• Discuss the reasons for their
positions, the order of insertion, and
the scalp incisions used for them and
how these incisions could be
extended for craniotomy.
Craniotomy Flaps • Describe in detail the technique of • Describe the implications of previous surgery in the • Demonstrate a variety of supratentorial
pterional craniotomy and its position of skull flaps and craniotomy. and posterior fossa craniotomies in
application to microsurgical exposure • Demonstrate standard pterional craniotomy and preparation for standard neurosurgical
of the basal cisterns. craniotomies for a variety of supratentorial elective and trauma procedures.
• Describe the arterial and nervous approaches, with particular attention to skin incision • Cortical incisions
anatomy as it relates to craniotomy placement and appropriate placement of the bone • Describe the anatomy of the major white

flaps and scalp flaps. flap. matter tracts in the cerebral hemisphere,
• Discuss the significance of the size • Demonstrate a midline posterior fossa craniotomy. and which parts of those carry significant
and shape of scalp flaps. • Describe different posterior fossa craniotomies in motor or special sensory pathways and
• Describe the placement and bony detail for access to different areas of the posterior the deficit likely to be caused if these are
anatomy of a pterional craniotomy. fossa. injured.
• Describe the placement of a trauma • Compare and contrast posterior fossa craniotomy • Perform appropriate cortical incision for
craniotomy for large acute with craniectomy in evidence-based terms. microscopic resection of a lesion (eg
hemispheric subdural haematoma. • Discuss the options for securing craniotomy flaps, and metastasis) from eloquent cortex.
• Demonstrate the safe use of compare the results in terms of stability, cosmesis, • Discuss the variety of means by which
perforators and burrs using a infection, and other complications. eloquent cortex can be localised, and the
Hudson brace, twist drill craniostomy accuracy, reliability and applicability to
and craniotomy using high-speed neurosurgical procedures.
craniotome.
• Demonstrate the use of the Gigli saw
for craniotomy.
• Compare and contrast the technique
of free bone flap and pedicled bone
flap for use in routine neurosurgical
procedures.
• Describe the anatomical factors
relevant to dural opening in
craniotomies.
Cortical incisions • Describe the topographical anatomy • Describe the preferred alignment and placement with
of the cerebral hemispheres with respect to sulci/gyri of a cortical incision into eloquent
respect to localisation of eloquent cortex.
cortex. • Describe the preferred orientation of a cerebellar
• Describe the anatomy of a typical incision for access to a deep lesion
cerebral gyrus and adjacent sulci • Describe the measurements from known landmarks
with respect to the thickness of the which may be used to define eloquent cortex
cortex and the local blood supply,
and indicate how this may affect
choice of alignment of cortical
incisions.
Lobectomy and • Describe the anatomical boundaries • Describe the tests which may be used to identify the • Demonstrate a traditional frontal
Surgery for intra- to the cerebral lobes and their location and extent of Wernicke's area with reference lobectomy.
axial lesions of the relationship to the skull to temporal lobectomy. • Discuss the differences in aims and
bones/sutures and identify the areas • Perform appropriate craniotomy and expose the brain extent of resection in a temporal
cerebral and
of eloquent cortex. and identify the extent of resection for a frontal and lobectomy for treatment of mesial
cerebellar • Define the extent of a traditional temporal lobectomy. sclerosis and low grade glioma.
hemispheres frontal lobectomy relative to the • Describe the anatomy of structures on the medial

cranial vault and identify which parts aspect of the temporal lobe, the deficit caused if
of the frontal lobe are removed and these are injured, and techniques to minimise risk of
which are resected. injury during temporal lobectomy.
• Discuss the deficits which are likely • Describe the anatomy of structures on the medial
to result from complete anatomical aspect of the frontal lobe, the deficit caused if these
removal of the dominant temporal are injured, and techniques to minimise risk of injury
lobe. during frontal lobectomy.
• Describe the extent of resection of • Describe the extent of the ventricular system in the
the temporal lobe in a traditional cerebral hemispheres, and whether this is expected
temporal lobectomy, the to be opened in a classical frontal and temporal
measurements used for this, and lobectomy.
whether this varies according to • Discuss complications which may arise from opening
side. the ventricular system during a lobectomy and
methods by which these complications may be
avoided
Approaches to • Demonstrate the appropriate • Reliably demonstrate insertion of ventricular catheter • Demonstrate exposure of the foramen of
intraventricular position to place a burr-hole for (via both the frontal and parieto-occipital Monro by both transcerebral and
lesions ventricular puncture through a approaches), using surface landmarks. transcallosal techniques.
frontal approach and also through a • Discuss in detail the advantages and disadvantages of • Discuss in detail the variety of
parieto-occipital approach. the transcortical and transcallosal approach to the microsurgical approaches to the 3rd
• Compare and contrast twist drill foramen of Monro (eg for colloid cyst resection). ventricle, their particular indications, risks
craniostomy and burr hole for • Perform an appropriately placed craniotomy in and specific complications associated with
ventricular access. preparation for colloid cyst resection. them.
• Describe the surface landmarks and • Discuss the microsurgical access to lesions in the 4th • Describe in detail third ventriculostomy,
orientation of the trajectory for ventricle, including whether incision of the vermis is including indications, ventriculoscopic and
ventricular puncture. required. open methods, and specific risks and
• Define the normal thickness of the • Discuss the site and trajectories which could be complications.
cerebral mantle and appropriate chosen for ventriculoscopy for lesions in various parts • Discuss the surgical approaches to a
lengths of catheters for ottimal of the lateral ventricle. lesion in the trigone of the left lateral
ventricular placement using these • Describe the significant features identifiable at ventricle, including the relative
approaches. surgery in the lateral ventricle and how to use them advantages and disadvantages of each.
to navigate within the ventricle. • Describe in detail the anatomy of the
foramen of Monro, surgical methods of
improving access from the lateral into the
third ventricle, and problems associated
with injury to structures in the region.
• Demonstrate the exposure and
identification of structures in the floor of
the fourth ventricle.
Approaches to the • Describe the gross anatomy of the • Describe the anatomy of the floor of the fourth • Describe the various approaches for open

brainstem brain stem, cranial nerves and ventricle. surgical exposure to the brainstem.
vascular structures of the posterior • Describe the brainstem nuclei and pathways at each • Discuss localisation of pontomedullary
fossa. level in the brainstem. lesions according to visible landmarks on
• Describe the anatomy of the cisterns • Describe the blood supply to the brainstem. the floor of the 4th ventricle.
adjacent to the brainstem. • Demonstrate a framed stereotactic biopsy
• Describe the relationships of the of a pineal lesion.
brainstem to the skull base, in
particular to the posterior clinoids,
petrous apex, clivus and foramen
magnum.
Surgical approaches • Discuss the particular anatomical • Describe the approach to the anterior cervical • Discuss the options for surgical access to
to the spine differences in the cervical, thoracic column, the anatomical relationships to this approach the anterior aspect of the upper thoracic
and lumbar spine and their influence and specific risks and complications. spine.
on choice of approach to the disc • Describe the alternative surgical approaches for • Discuss surgical approaches to the
space at each level. thoracic discectomy. anterior aspect of the thoracolumbar
• Demonstrate exposure of the • Describe the relationship of the ribs to the thoracic junction.
posterior aspect of the spinal column disc space, and methods of accurately determining • Describe the surgical options for exposure
in preparation for laminectomy the level during surgical discectomy. of the anterior aspect of the upper
• Decompression of spinal cord cervical spine (C1, C2, C3).
• Describe the anatomical extent of • Describe the anterior relationships to the
the spinal cord, the relationship of lumbosacral lesion.
neurological level and vertebral
level, and the blood supply to the
cord
Surgical approaches • Demonstrate thoracic discectomy by

to the spine different approaches.
• Demonstrate the set up and surgical
exposure for odontoid screw fixation.
• Demonstrate the exposure and insertion
of lumbar pedicle screws.
Approaches to the • Describe the anatomical relations of the pineal. • Demonstrate the positing of the patient in
pineal gland • Describe the anatomy of the infratentorial space, and each of the possible positions for access
structures which would be encountered in to the pineal, and be able to discuss with
approaching the pineal by this route. the anaesthetist specific problems which
• Discuss the advantages and disadvantages of may be encountered during the
stereotactic biopsy of a pineal tumour. procedure and how to minimise the risks
• Discuss the different approaches available for of these complications.
exposure of the pineal and the advantages and • Demonstrate the craniotomy in
disadvantages of each (include infratentorial and preparation for a pineal tumour by both

transtentorial approaches). the infra- and supratentorial approach.

• Describe in detail the positioning options for the each • Discuss the options for the trajectory for
of the different approaches to the pineal, and the a framed stereotactic biopsy of a pineal
advantages and disadvantages of each. lesion, and the relative risks and merits
of each approach.
• Demonstrate a stereotactic biopsy of a
pineal lesion.
• Demonstrate the infratentorial exposure
of the pineal region.
Decompression of • Demonstrate a cervical laminectomy. • Demonstrate anterior cervical

spinal cord discectomy, fusion and stabilization.
• Describe in detail the method of thoracic
discectomy using both
costotransversectomy and transthoracic
approaches.
•
Decompression of • Define the anatomical relationship of • Demonstrate the exposure, and accurately identify • Demonstrate a lumbar microdiscectomy
cauda equina and the spinal nerve roots to the disc the nerve root for a lumbar microdiscectomy. and neurolysis .
spinal nerves spaces in the cervical, thoracic and • Perform a decompressive lumbar laminectomy. • Demonstrate intradural exposure of the
lumbar spine. • Describe radiological findings of intradural and cauda equina and perform precise
• Describe in detail the pathological extradural compression of the cauda equina. anatomical closure.
changes in lumbar canal stenosis, • Discuss the management options for
and their implications for surgery. intra-operative dural tear and CSF leak.
• Describe the typical surgical • Spinal stabilisation and fusion techniques
approach to extradural compressive • Demonstrate the exposure of the atlanto-
lesions of the cauda equina. occipital junction for stabilisation
procedure.
• Describe the methods of C1/2
stabilisation in detail.
• Describe the procedure of odontoid screw
fixation.
• Describe the entry points, trajectories,
and complication avoidance techniques
for cervical stabilisation using lateral
mass screws and C1/2 transarticular
screws.
• Describe surgical options for stabilisation
of the thoracic spine.
• Describe the anatomical landmarks,
technique and complication avoidance
strategies for the insertion of lumbar

pedicle screws.
• Demonstrate anterior cervical discectomy
fusion and instrumentation.
Spinal stabilisation • Define the terms spinal instability, • Discuss the surgical options for management of • Demonstrate the anatomical landmarks,
and fusion spinal fusion, and spinal internal lumbar canal stenosis with associated minor (Grade technique and complication avoidance
techniques fixation (stabilisation). 1) degenerative spondylolisthesis, including the strategies for the insertion of lumbar
• Define the terms spondylolisthesis advantages and disadvantages of the different pedicle screws.
and spondylolysis, and any management options. • Discuss the potential advantages and
relationship they may have. • Describe anterior cervical discectomy and fusion by disadvantages of lumbar interbody fusion
• Discuss different types of spinal Cloward, Smith-Robinson and interbody cage compared to posterolateral fusion.
fusion. techniques. • Discuss the mechanism of stabilisation
• Define the role of the various • Compare and contrast the options of anterior cervical utilised by inter body devices, and
structural elements of the spine discectomy with and without fusion. compare their effectiveness with other
(joints, ligaments, discs) in • Define factors which affect bone union following techniques in the lumbar and cervical
maintaining physiological stability. spinal fusion. regions.
• Demonstrate familiarity and • Discuss the options for reduction of cervical
understanding of the role of external subluxation with jumped facets.
spinal orthosis (collars and braces), • Define the named fracture types involving C1 and C2,
and their suitability for management and the treatment options available for each
of instability at different spinal
levels.
• Demonstrate the application of
cervical traction and describe the
management in terms of nursing
care and recommended weights for
management of cervical subluxation
• Demonstrate the application of a
halo-thoracic brace
Surgical equipment • Describe the history and • Discuss effects of diathermy on bleeding dural • Demonstrate stereotactic biopsy of
development of surgical diathermy. sinuses. intracranial lesions.
• Discuss the differences between • Demonstrate the use and limitations of the • Demonstrate frameless stereotactic
bipolar and monopolar diathermy neurosurgical operating microscope. localisation in spinal surgery.
and the application of each to safe • Describe the mechanism of action of the surgical • Demonstrate use of the operating
neurosurgical practice. ultrasonic aspirator, its uses and limitations. microscope with complete familiarity.
• Describe the difference between • Demonstrate frameless stereotactic localisation, • Demonstrate accurate use of high speed
cutting and coagulation settings of including data acquisition, data transfer, registration air drill in bone dissection for basic skull
diathermy. and localisation. base exposure and in spinal applications.
• Describe the surgical risks of • Demonstrate framed stereotactic localisation, • Describe the procedure of
diathermy including micro-shock and including frame application, data transfer and electrophysiological localisation for
burns. coordinate computation, and localisation. functional stereotactic surgery.

• Describe factors affecting risk of fire • Demonstrate the use of a high speed air drill for • Demonstrate a percutaneous rhizotomy
hazard in surgery. accurate bone dissection in the laboratory and in of the trigeminal ganglion.
• Demonstrate safe and effective use cranial and spinal applications. • Discuss the surgical application of lasers,
of surgical diathermy, using • Describe the mechanisms of action and use of the including risks, uses and limitations
monopolar and bipolar in appropriate radiofrequency generator.
circumstances. • Discuss the principles and uses of ultrasound in
• Demonstrate the setup and neurosurgery.
balancing of the neurosurgical •
operating microscope, and be able to
drape it in a sterile manner.
• Describe the principles of stereotaxy,
and how this is practically applied
using framed and frameless
stereotaxy.
• Describe the mechanical principles of
the high-speed air drill, and of
cutting and diamond burrs.
• Demonstrate safe use of Hudson
Brace the perforator and burr, Gigli
saw and the high-speed air
craniotomy.
Skull base surgery • Define the skull base • Describe the detailed anatomy of the skull base and • Discuss the options for resection of
upper cervical spine, including neurovascular lesions in the cavernous sinus.
relationships, and also relationships to orbital, facial, • Describe the trans-oral and mid-facial
subtemporal and oro-pharyngeal structures. approaches to the skull base.
• Describe the history and anatomical principles in • Discuss the relative merits and risks of
trans-sphenoidal surgery. the retrosigmoid, translabarynthine, far-
• Describe skull base methods utilised for resection and lateral (trans-condylar) and transpetrosal
repair of lesions involving the frontal sinus. approaches to parts of the brain stem,
• Describe the approaches and potential complications with particular reference to which areas
of different surgical approaches to the pituitary fossa. are well exposed and which are not.
• Describe the approaches for skull base
craniotomies, including anterior fossa
floor, orbitozygomatic, petrosal and far-
lateral (transcondylar) posterior fossa
approaches.
• Demonstrate the trans-oral and mid-
facial approaches to the skull base.
• Demonstrate the retrosigmoid and far-
lateral (trans-condylar) approaches to
parts of the brain stem.

• Demonstrate the approach for skull base

craniotomies, including anterior fossa
floor, orbitozygomatic, petrosal and far-
lateral (transcondylar) posterior fossa.
SYLLABUS MODULE – PAEDIATRIC NEUROSURGERY AND DEVELOPMENTAL NEUROLOGY
Neurological • Describe the normal milestones of • Describe normal child hood and adolescent • Describe normal child hood and
evaluation neurological development in the neurological development. adolescent neurological development.
infant.
• Describe the normal neurological
examination of a neonate.
• Describe the Babinski, Morrow,
stepping and grasp reflexes at
different ages.
• Define the Apgar score.
• Describe modifications of the
Glasgow coma score for use in
paediatrics.
• Describe normal and abnormal
states of the fontanelles.
Neural tube defects • Describe the risk factors associated • Discuss the early management of spina bifida cystica. • Discuss the clinical features, causes,
including spinal with the development of neural tube • Describe the intracranial anomalies commonly diagnosis and management of tethered
dysraphism defects. associated with spina bifida. cord syndrome.
• Describe the spectrum of neural tube • Discuss the presentation and management of • Discuss the specific problems and
defects. lumbosacral lipomata. management associated with spina bifida
• Discuss the significance of sacral in late childhood and adolescence.
skin lesions in infants. • Discuss the features on neurological and
• Define diastematomyelia. radiological diagnosis of major prognostic
significance in a neonate with
encephalocele.
• Demonstrate the closure of all types
of neural tube defects including
techniques of skin coverage.
Craniovertebral • Define the classification of Chiari • Describe the clinical features of the various types of • Discuss the management options for

junction anomalies malformations. Chiari malformations at different ages. hydrocephalus associated with Chiari
malformations.
• Discuss the management options for
syrinx associated with Chiari
malformations.
• Discuss platybasia and basilar
invagination and their associations.
Hydrocephalus • Describe normal CSF production, • Compare and contrast different shunt techniques • Describe the technique of third
circulation and absorption. such as VP, VA and LP diversions. ventriculostomy.
• Discuss the classification of • Discuss the indications and contraindications of third • Demonstrate the insertion of a VP shunt.
hydrocephalus. ventriculostomy. • Discuss the different types of shunting
• Discuss the causes of neonatal • Define the slit ventricle syndrome. systems available.
hydrocephalus. • Define Dandy-Walker malformation. • Discuss the options of flow and pressure
• Discuss the different management • Discuss aqueduct stenosis. regulated shunts.
options for different types of • List the complications of shunt insertion. • Discuss in detail the management of an
hydrocephalus. infected shunt.
• Discuss treatment options for slit
ventricle syndrome.
Craniosynostosis • Describe the normal ages at which • Discuss the theories regarding premature suture • Describe the named craniofacial disorders
the sutures close closure. associated with craniosynostosis.
• Discuss the various types of craniosynostosis and • Describe the spectrum of management
their clinical features. techniques for craniosynostosis.
• Discuss the indications for treating craniosynostosis. • Discuss management of complex
• Discuss the relationship of craniosynostosis and craniofacial dysmorphic syndromes.
intracranial pressure. • Demonstrate the surgical management of
sagittal craniosynostosis.
Arachnoid cysts • Describe the common locations of • Discuss the indications for treatment of an arachnoid • Compare and contrast techniques of
arachnoid cysts. cyst. shunting and fenestration of arachnoid
• Discuss the theories regarding • Discuss the management options for a symptomatic cysts.
formation of sylvian arachnoid cysts. arachnoid cyst.
• Describe clinical features that may
be associated with arachnoid cysts.
Paediatric trauma • Discuss aspects of head injuries • Describe the clinical and radiological features of • Discuss post traumatic brain swelling in
peculiar to children. shaken baby syndrome. infancy and its management.
• Discuss aspects of general trauma • Discuss the features suggestive of child abuse. • Describe the methods of performing
management peculiar to children. • Define a growing fracture and discuss its cranioplasty in children of various ages.
• Discuss the normal radiological management.
appearance of the cervical spine in

infancy and childhood.

• Describe the age at which there
would be complete ossification of C2.
Miscellaneous • Discuss the common spectrum of • Discuss differences in the management of gliomas • Discuss the management of subdural
paediatric CNS tumours. between children and adults. empyema in children.
• Contrast the features of common • Discuss the effects of radiation on the developing • Diiscuss the prognostic factors of
paediatric gliomas compared to adult brain. paediatric fourth ventricular tumours.
gliomas. • Discuss differential diagnosis of fourth ventricular • Discuss dysembryoplastic neuroepithelial
• Describe the thickness of the tumours. tumours (DNET) and their management.
cerebral mantle in childhood. • Define holoprosencephaly. • Discuss surgical options for the treatment
• Describe in detail the clinical • Discuss the various neurological manifestations of in- of epilepsy in children.
features of paediatric meningitis and utero infections.
its management.
• Discuss the issues regarding consent
in minors.
SYLLABUS MODULE – PAIN
Pathophysiology of • Describe the anatomy of pain • Explain how central or spinal neurostimulation is • Discuss the role of the autonomic nervous
pain pathways within the peripheral and thought to modulate pain perception. system in chronic pain.
central nervous systems. • Describe subcortical and brainstem sites
• Describe the physiology of that appear to be involved in the
nociception. modulation of nociception to targets for
• Describe the clinical features of the deep brain stimulation for pain control.
basic pain syndromes, including: • Describe the functional anatomy of the
• acute thalamic nuclei.
• chronic • Discuss the possible therapeutic
• nociceptive interventions for pain management
• neuropathic (including complex related to thalamic nuclei.
regional pain syndromes)
• musculofascial
• malignant
General and • Discuss the interaction of • Discuss methods of assessing outcomes of pain • Discuss specific problems associated with
psychosocial factors physiological, pathological and management. inappropriate post operative pain
psychosocial components of pain. • Describe commonly used pain and disability management.

in pain management • Explain the rationale for assessment scales. • Describe the specific clinical features of
multidisciplinary management of various types of non organic pain-type
pain disorders. behaviour.
• Discuss controversies associated • Describe the clinical features of drug
with pain management following dependence.
intracranial and spinal surgery.
Analgesics and pain • Describe the major classes of • Describe the mode of action of the major classes of • Describe the indications,
relief medications commonly used for pain medications listed in level one. contraindications, drug interactions and
treatment eg. opioids, nonsteroidals side effects of the major classes of
and paracetamol, antidepressants, medications listed in level one.
anticonvulsants.
• Describe the pharmacology of local
anaesthetic agents (e.g., lignocaine,
marcain) and the use of adrenaline
with local anaesthetic agents.
Facial pain including • Describe in detail the surgical • Describe the percutaneous techniques of trigeminal • Demonstrate percutaneous techniques of
trigeminal neuralgia anatomy of the trigeminal nerve. rhizotomy including radiofrequency, glycerol and trigeminal rhizotomy including
• Describe the clinical features of balloon compression. radiofrequency, glycerol and balloon
trigeminal neuralgia, trigeminal • Describe alternative procedures to the peripheral compression.
neuropathic pain, and atypical facial branches of the trigeminal nerve. • Discuss the potential complications of
pain. • Describe and contrast the approaches to the percutaneous procedures for trigeminal
• Discuss the medical management of cerebellopontine angle for microvascular neuralgia.
trigeminal neuralgia. decompression or rhizotomy of the trigeminal and • Hemifacial spasm
glossopharyngeal nerves. • Describe microvascular decompression of
the facial nerve and complication
avoidance.
• Discuss the advantages and
disadvantages of microvascular
decompression versus percutaneous
procedures in the management of
trigeminal neuralgia.
• Discuss the options if no vascular
compression is found at MVD surgery.
• Demonstrate microvascular
decompression of the trigeminal nerve.
• Discuss the role of radiosurgery in the
management of trigeminal neuralgia.
• Discuss the role of intra operative
monitoring during microvascular
decompression.

Glossopharyngeal • Describe the clinical syndrome and • Discuss the medical and surgical management of • Describe the detailed surgical anatomy of
neuralgia differential diagnosis of glossopharyngeal neuralgia. the glossopharyngeal and vagus nerves
glossopharyngeal neuralgia. and the appropriate extent of resection
for glossopharyngeal neuralgia.
Hemifacial spasm • Describe the clinical syndrome and • Discuss the medical (including botulinum toxin) and • Demonstrate microvascular
differential diagnosis of hemifacial surgical management of hemifacial spasm. decompression of the facial nerve.
spasm.
Nerve blocks, • Describe peripheral nerve blocking • Describe indications for ablative peripheral nerve • Discuss the theoretical basis of
electrical procedures including the techniques procedures. acupuncture.
stimulation and expected outcomes. • Discuss the methods of permanent neural
• Discuss the potential complications block including neurolytic blocks (eg
radiofrequency
of a peripheral neural blockade phenol, alcohol), ablative neurosurgical
lesions for pain (including anaphylaxis, neural injury, procedures (eg radiofrequency and
relief and intravascular or intrathecal neurectomy) and augmentative
administration). neurosurgical procedures (eg
stimulation).
• Review the indications and
pathophysiological basis for
radiofrequency facet denervation.
• Describe the techniques of spinal cord
stimulation.
• Discuss the role of ablative brain and
brainstem procedures (eg cingulotomy,
mesencephalic tractotomy, trigeminal
tractotomy) in the management of
chronic benign pain and cancer pain.
• Discuss the role of spinal cord stimulation
in the management of pain.
• Describe the maintenance and
programming of spinal cord stimulation
systems.
• Discuss the role of peripheral nerve
stimulation in the management of pain.
Intraspinal narcotic • Demonstrate the percutaneous insertion of epidural • Discuss the role of intraspinal drug
infusions and intrathecal catheters. administration in pain management.
• Describe the classes of drugs used for intraspinal • Compare the different methods of
administration in the management of pain. intraspinal drug administration (eg
• Discuss their mechanism of action. Epidural vs intrathecal, tunnelled catheter
• Discuss the risks and potential complications of vs implanted infusion system).

intrathecal drug administration. • Demonstrate the insertion of an

intraspinal drug infusion pump.
• Describe the maintenance and
programming of spinal drug
administration systems.
• Recognize and evaluate malfunctions of
intraspinal drug administration systems.
•
Spinal cord ablative • Discuss the indications for spinal cord ablative • Describe the techniques of spinal cord
procedures procedures (eg DREZ lesions, cordotomy and ablative procedures (eg DREZ lesions,
myelotomy) in the management of pain. cordotomy and myelotomy).
• Describe the role of DREZ lesioning in the
overall management of the patient with
deafferented pain.
• Demonstrate the procedure of DREZ
lesioning including localization and lesion
generation in cases of root avulsion.
SYLLABUS MODULE – PERIOPERATIVE CARE
History Examination • Consistently demonstrate complete

history examination and appropriate
pre operative workup of all patients,
taking into account all body systems
and relevant personal and family
history.
• Consistently demonstrate complete
and thorough history and
examination of neurological patients
presenting for surgery.
•
Blood coagulation • Demonstrate a knowledge of the • Demonstrate knowledge of the
and transfusion coagulation pathways. congenital/abnormalities for coagulopathies.
• Describe the indications and • Discuss the indications and mechanisms and risks for
complications of a blood, platelet intra-operative blood salvage.
and plasma protein transfusion. • Discuss the indications and contra-indications for anti
• Describe the clinical principles for coagulation and anti platelet usage in neurosurgical

safe transfusion including patients.

appropriate laboratory testing. • Describe the diagnosis and treatment of disseminated
common or severe coagulations (ie DIC).
D.V.T. and • Describe the pathophysiology of

pulmonary venous thrombosis and the general
embolism predisposing factors for a DVT.
• Discuss the specific risk factors in
neurosurgical patients.
• Describe in detail the clinical
features and appropriate diagnostic
test and treatment of a DVT and
pulmonary embolism.
• Discuss the clinical indications and
trials for DVT Prophylaxis as it
relates to neurosurgery.
Fever in • Discuss in detail causes and

neurosurgical appropriate investigations for
patients neurosurgical patients.
• Discuss in detail causes of fever in
neurosurgical patients and how to
diagnosis a CNS.
• Discuss the appropriate
investigations of a patient with a
fever and common organisms in
neurosurgical infection.
• Discuss of the major class of modern
antibiobiotic, antimicrobial spectrum
and the associated side effects.
• Discuss the use of CSF penetration
of the above antibiotics.
• Discuss the use of universal
precautions in preventing infection.
Acute Confusion in • Discuss indication and risks

the Peri Operative associated with medical therapy in
Patient an agitated patient.
• Demonstrate a knowledge of the
appropriate pharmacological agents
to manage a patient who is agitated.
• Discuss the examination and

appropriate investigations of the

causes of confusion.
• Demonstrate an ability to perform a
neurological examination in a
confused patient.
Perioperative • Discuss the incidence and etiological

factors of seizures following a
craniotomy.
• Describe the classification of
seizures.
• Discuss the knowledge of the
common anti-epileptic medications
and their side effects.
• Discuss the management of a
postoperative seizures and seizure
control in patients.
• Discuss the use of anti-prophylactics
and their duration
Informed consent • Discuss in detail the concept of • Demonstrate an ability to interact effectively with a • Discuss the importance of tracking
and medico-legal informed consent. patient and family members following a surgical morbidity, mortality and patient
aspects • Demonstrate an ability to obtain complication. outcomes.
informed consent. • Discuss the common causes of medical
• Demonstrate an ability to maintain malpractice and effective measures to
accurate medical records. reduce risk.
• Demonstrate an ability to maintain a
personal patient morbidity/mortality
outcome database.
• Discuss current medico legal aspects of
informed consent.
Persistent headache • Demonstrate an ability to perform a • Discuss the incidence and etiological factors of
after craniotomy neurological examination of a patient headaches following a craniotomy.
with a head ache following a • Discuss the knowledge of the common analgesic
craniotomy. medication and their side effects to manage a patient
• Discuss the appropriate investigation with a postoperative headache.
in a patient with a postoperative
headache
Intracranial • Describe the pathophysiology of • Demonstrate an understanding of the appropriate •

Hypertension intracranial hypertension. investigation to diagnosis with intracranial •

• Demonstrate an understanding of hypertension. • Demonstrate emergency ventriculostomy.

the clinical manifestation of • Demonstrate the treatment options for the various • Describe placement of emergency burr
intracranial hypertension. causes of intracranial hypertension. holes.
• Demonstrate an ability to perform a • Discuss the common conditions that cause sodium • Discuss in detail the role of
clinical examination and direct abnormalities. decompressive craniotomy and perform
emergency management on a • Discuss the risks and roles of ventricular puncture this proficiently when appropriate.
patient with intracranial and lumbar puncture in the presence of intracranial
hypertension. Describe in detail the hypertension.
relationship between intracranial
hypertension and cerebral perfusion
and the appropriate management.
• Demonstrate an understanding of
the symptoms and signs suggestive
of raised intracranial hypertension.
Epilepsy after • Discuss the role of prophylactic antiepileptic • Demonstrate the diagnosis of
craniotomy medication. pseudoseizures and discuss the use and
limitations of EEG's.
• Discuss the role and controversies
associated with prophylactic medication.
Management of peri • Demonstrate the management and • Demonstrate knowledge of the etiological cause of DI.
operative fluid, diagnosis of circulation disorders. • Demonstrate an ability to diagnosis DI.
electrolyte and • Post operative fluid requirements in
neurosurgical patients.
circulatory status
• Identification and management of
hyponaraemia, cerebral salt wasting
and diabetes inc.
• Describe the pathophysiology of
hypertension.
• Discuss the etiological causes of
hypertension.
• Demonstrate a detailed knowledge
of hemodynamic monitoring.
• Demonstrate detailed understanding
of water and electrolyte including
fluid balances and losses.
• Discuss why sodium, magnesium
and water balance are particularly
important.
• Demonstrate a knowledge of the
physiology of the hypothalamic -

pituitary axis.
• Discuss the principle
physiology/pathophysiology of water
balance.
• Discuss the role of mannitol and
diuretics in neurosurgery and
problems associated with this.
Peri Operative • Discuss the indications, benefits and risks for •

Steriod Use perioperative steroid use.
Principles of • Demonstrate appropriate forward • Describe the principles of spinal injury rehabilitation • Demonstrate an ability to develop patient
Discharge Planning planning in all patients. and stroke rehabilitation focused rehabilitation goals and program
and Rehabilitation • Discuss in detail the principles of planning.
planning and post operative care as • Demonstrate an ability to lead a
it relates to discharge planning and multidisciplinary rehabilitation team
continuity of care.
• Discuss the general principles of
rehabilitation.
• Discuss in detail the neurobiological
process underlying functional brain
recovery.
• Describe the principles of head
injury rehabilitation.
• Describe who is the appropriate
person to give informed consent.
Diagnosis of brain • Discuss the indications for brain • Discuss the differences in regional and international • Demonstrate an ability to oversee junior
death death. legislations relating to brain death. medical staff in the diagnosis of brain
• Demonstrate the formal assessment • Demonstrate an ability to examine a patient to death.
of brain death. determine brain death. • Discuss the issues associated with the
• Demonstrate ability to interpret ancillary criteria fro removal of life support.
brain death. • Discuss potential perceived conflicts of
interest for neurosurgeons being involved
in organ donation and brain death
including morale issues.

SYLLABUS MODULE – PERIPHERAL NERVE
Peripheral nerve • Discuss the classifications of • Discuss the differential diagnosis and investigation of • Discuss diagnostic features of the
injuries and peripheral nerve injury. entrapment neuropathies. uncommon entrapment neuropathies.
entrapment • Expertly demonstrate clinical • Discuss the operative and non-operative treatment of • Expertly demonstrate the clinical
examination of common peripheral entrapment neuropathies. examination of uncommon peripheral
neuropathies
nerve lesions. • Describe the procedure of peripheral nerve. nerve lesions.
• Describe the symptoms and signs of electrophysiological studies. • Describe the symptoms and signs of
common entrapment neuropathies. • Describe the uses and limitations of uncommon entrapment neuropathies.
• Describe the surgical treatment of electrophysiological studies in peripheral nerve • Describe in detail the surgery of the
carpal tunnel syndrome and ulnar lesions. uncommon sites of peripheral nerve
nerve entrapment at the elbow. • Describe in detail the surgery of the common sites of entrapment.
• Describe Wallerian degeneration. peripheral nerve entrapment. • Describe the exposure of the brachial
• Describe the rating scale of motor • Describe stretch injury, missile injury and avulsion plexus.
power. injury: definition, non-operative management and • Describe the uses and limitations of intra-
• Describe nerve regeneration. indications for surgery. operative electrophysiological nerve
• Discuss the optimal timing of surgery for peripheral evaluation.
nerve injuries. • Discuss the techniques of nerve repair
• Discuss non-surgical peripheral neuropathies e.g. and grafting.
brachial plexopathy, mono and polyneuropathies. • Discuss in detail the surgical options for
decompression of the ulnar nerve at the
elbow.
• Interpret electrophysiological studies of
the common entrapment neuropathies.
• Independently perform decompression of
entrapment neuropathies.
• Demonstrate exposure of the brachial
plexus.
• Demonstrate nerve repair techniques and
nerve grafts.
Autonomic nervous • Discuss the clinical features of a • Describe the various conditions for which • Describe the surgical approaches for an
system disorders patient with hyperhidrosis. sympathectomy could be considered therapeutic. upper thoracic sympathectomy.
• • Discuss the risks and complications of • Demonstrate an upper thoracic
sympathectomy. sympathectomy.

Neoplasms of • Describe the classification of • Describe the gross and microscopic pathological • Describe the operative and non-operative
peripheral nerves peripheral nerve tumours and their features of peripheral nerve tumours. management of a patient with a
relationship to neurofibromatosis. • Identify the diagnostic radiological features for peripheral nerve tumour.
• Describe the clinical presentation, peripheral nerve tumours. • Demonstrate the exposure of a peripheral
epidemiology and natural history of nerve tumour.
peripheral nerve tumours. • Independently perform the resection of a
• Demonstrate the clinical assessment peripheral nerve tumour with appropriate
of a patient with peripheral nerve reconstruction.
tumour. • Discuss the treatment options for a
malignant peripheral nerve tumour.
SYLLABUS MODULE – PSYCHIATRY AND NEUROPSYCHOLOGY
Abnormal Illness • Describe the features of abnormal • Define and discuss the commonly used terms • Describe in detail the bio-psycho-social
Behaviour illness behaviour (including not only including somatisation, hypochondriasis, hysteria, model of abnormal illness behaviour.
the problems of patients with bodily conversion disorder, malingering, chronic fatigue • Describe in detail how the features of
symptoms for which no adequate syndrome. abnormal illness behaviour impacts on
organic cause can be found, but also the management of chronic pain.
those who deny the presence of • Describe medicolegal implications of
disease which is obvious to others). abnormal pain behaviour and incorporate
• Define acute confusional state. this in a meaningful and constructive way
• Discuss the assessment, differential in medical assessments and reports.
diagnosis and investigation of an
acutely confused patient.
• Define dementia.
• Discuss the assessment, differential
diagnosis and investigation of a
patient with dementia.
• Identify treatable causes of
dementia.
Principles of • Discuss the use of • Describe examples of neuropsychological

Neuropsychological neuropsychological testing and its sequelae that commonly occur after brain
Testing application to the following areas: injury.
• General intellectual ability
• Reasoning and problem solving
ability

• Receptive and expressive language

ability
• Visuoperceptual and
visuoconstructional ability
• Speed of information processing
• Attention and concentration
• Memory and learning
• Executive functioning (i.e. problem
identification, goal formulation,
generation of alternative responses,
choosing and initiating responses,
planning and organising, monitoring
and regulating responses)
• Describe the testing instruments
that can be used to assess a
patient's cognitive functioning.
• Describe the testing instruments
that can be used in
neuropsychological testing.
Psychiatric • Describe the principles of a • Discuss the application of the DSM IV. Describe the • Define the following conditions:
Evaluation psychiatric evaluation and general structure of this text. • Depressive Disorders
formulation of a diagnosis. • Describe the Multiaxial Assessment Classification • Anxiety Disorders (including post
• Discuss the clinical uses of sedative (Axis I-V) and clinical application of the DSM IV traumatic stress disorder)
drugs, particularly benzodiazepines system. • Conversion Disorder
(uses, limitations and dependence.) • Somatoform Disorders
• Discuss the uses, indications and • Personality Disorders
classification of psychotropic drugs. • Pain disorder
• Discuss features and management of • Adjustment disorders
drug dependency. • Psychological Factors Affecting Medical
Condition
• Discuss pharmacology of antidepressant
medication. Describe indications and side
effects of tricyclics, MAO Inhibitors and
serotonin selective reuptake inhibitors
(SSRIs)
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Psychosurgery • Discuss the history of • Describe the anatomical lesions for

psychosurgery. different psychiatric conditions.
• Discuss the impact of Egas Moniz in • Discuss the effectiveness of surgery in

neurosurgery. the treatment of depression.

• Discuss in detail local legislation
regarding psychosurgery.
SYLLABUS MODULE – SPINAL SURGERY
Operative Spinal • Refer to the Operative Surgery • Refer to the Operative Surgery syllabus module of the • Refer to the Operative Surgery syllabus
Surgery syllabus module of the curriculum. curriculum. module of the curriculum.
Anatomy • Refer to the Anatomy syllabus • Refer to the Anatomy syllabus module curriculum. • Refer to the Anatomy syllabus module
module curriculum. curriculum.
General • Demonstrate history acquisition and • Describe the indications and limitations of spinal • Discuss the indications for, and
detailed physical examination on surgery to relief different types of neurological deficit physiology of, intraoperative spinal cord
patients with spinal disorders. (spinal cord, cauda equine and nerve root). monitoring.
• Demonstrate the normal anatomical • Describe the indications and limitations of spinal • Describe the management options for
features of plain cervical xrays, CT surgery to relief different pain syndromes. intraoperative and postoperative
scans and MRI scans of the cervical, • Discuss in detail the management options for cerebrospinal fluid leaks.
thoracic and lumbar regions. patients in whom spinal surgery has failed to relieve • Discuss the role of rehabilitation in
• Discuss the management of symptoms patients with spinal disorders.
postoperative complications of spinal • Describe the differences between spinal fusion and • Describe the technical aspects and
surgery including hematoma, spinal instrumentation, and the indications, risks and limitations of intraoperative spinal cord
infection, spinal fluid leak, new limitations of each. monitoring.
neurologic deficit.
• Define the terms spondylosis,
spondylolysis and spondylolisthesis.
• Describe the clinical assessment and
differential diagnosis spinal pain.
• Define spinal stability and describe
how it is most appropriately
assessed.
• Demonstrate the expected age-
related changes not indicative of
significant spinal pathology in elderly
patients on plain cervical xrays, CT
scans and MRI scans of the cervical,
thoracic and lumbar regions.
Biomechanics and • Describe in detail the normal • Discuss the biomechanics of the craniocervical • Discuss the concepts of load bearing

kinematics of the movements of the vertebral column junction, cervical spine and thoracolumbar and relative to each section of the vertebral
spine at each level. lumbar spine. column.
• Describe the normal alignment of • Discuss the concepts of motion of the vertebral • Discuss the effects of abnormal loading
the vertebral column. column including instantaneous axis of rotation. on individual spinal components such as
• Discuss the factors responsible for vertebrae, discs and ligaments.
stability of the spinal column. • Discuss the biomechanical consequences
of common procedures such as
laminectomy.
Degenerative and • Describe in detail the clinical • Discuss the theories of spinal stability eg Punjabi and • Discuss the role of corpectomy in the
inflammatory features of neurological compression White, Denis and AO classification. management of cervical disorders.
disorders syndromes of the spine including • Compare and contrast indications for anterior and • Discuss the management of rheumatoid
radiculopathy, myelopathy, cauda posterior approaches to the cervical spine for the cervical disease and describe factors
equina compression and neurogenic treatment of herniated cervical discs, spondylosis, which make it different from the
claudication. and instability. management of non-rheumatoid disease.
• Discuss the importance and relative • Compare and contrast the indications for anterior • Discuss the clinical features and
urgencies of the various compressive cervical discectomy with and without anterior management of ankylosing spondylitis.
syndromes especially cauda equina interbody fusion. • Compare and contrast the various
syndrome. • Describe the pathological and radiological features of approaches to a herniated thoracic disc.
• Discuss the differential diagnosis of OPLL and DISH. • Discuss the indications for lumbar fusion
cervical, thoracic, and lumbar pain. • Discuss the management options of degenerative for iatrogenic disease and degenerative
• Discuss the effects of rheumatoid lumbar spondylolisthesis in association with canal disease.
arthritis on the spine. stenosis. • Discuss the controversies surrounding the
• Describe the indications for cervical, • Discuss the clinical features, pathological findings and management of asymptomatic
thoracic and lumbar discectomy. management of osteoporosis. radiological cord compression from
• Demonstrate the expected age- • Discuss the appropriate radiological investigations for degenerative disease.
related changes not indicative of patients with degenerative spine disease. • Discuss the controversies surrounding
significant spinal pathology in elderly kyphoplasty and vertebroplasty.
patients on plain cervical xrays, CT
scans and MRI scans of the cervical,
thoracic and lumbar regions.
Trauma • Describe in detail the clinical • Classify fractures, dislocations, and ligament injuries • Discuss the indications for types of
features and pathophysiology of of the craniocervical region, subaxial cervical spine, imaging and re-imaging.
spinal cord injury including complete thoracic, thoracolumbar junction, lumbar and sacral • Discuss the implications for the
and incomplete injury, anterior cord spine. management of trauma in the presence
injury, central cord injury, Brown- • Discuss the indications for surgical management of of ankylosing spondylitis.
Sequard injury, cruciate paralysis, spinal instability. • Discuss the pathogenesis, clinical
conus syndrome and sacral sparing. • Discuss briefly the concept of grading schemes for presentation and management options for
• Describe the early management of spinal cord injury and myelopathy. post traumatic syringomyelia.
spine and spinal cord injured • Discuss the indications, uses and relative • Demonstrate the placement and
patients including immobilization, effectiveness of common spinal orthoses. management of cranial traction devices
traction, reduction, appropriate • Discuss the degree of segmental and regional for reduction and immobilization of the
radiographic studies and medical immobilization different spinal orthoses provide. unstable cervical spine.

management. • Discuss the management principles for penetrating • Demonstrate the application and
• Discuss in detail the definitions of wounds to the spine. management of a halo-thoracic brace.
spinal stability. • Discuss non-operative and operative treatment • Demonstrate the application and
• Describe the named fractures in the options for fractures and dislocations affecting the management of cervical traction for
cervical spine. atlas and axis. instability.
• Demonstrate the normal anatomical • Compare and contrast the indications for non- • Discuss the indications and techniques for
features of plain cervical xrays, CT operative treatment, anterior approaches and complex internal fixation for spinal
scans and MRI scans of the cervical, posterior operative approaches for the treatment of trauma.
thoracic and lumbar regions. fractures and dislocations of the subaxial cervical • Discuss current theories of spinal cord
• Describe the indications for spinal spine. regeneration.
immobilisation and/or investigation • Describe in detail the indications for, risks and • Discuss the controversies surrounding the
in trauma patients. complications, and alternative techniques for cervical management of compression fractures.
• Describe the appropriate spinal traction. Demonstrate, or describe in detail, the • Describe the controversies surrounding
investigations required for trauma application of cervical traction. the management of odontoid fractures.
patients considered at risk of having • Describe in detail the indications for, risks and • Discuss the controversies surrounding
spinal injury. complications, and alternative techniques for cervical and evidence relating to the use of
• Discuss the appropriate radiological spinal traction. Demonstrate, or describe in detail, the steroids in spinal injury.
investigations for trauma patients application of cervical traction, and describe the • Discuss controversies, risks and
with spinal trauma. subsequent management of the patient in traction. indications of dynamic radiological
• Demonstrate the expected age- • Describe in detail the indications for, risks and investigations in acute spinal trauma.
related changes not indicative of complications, and alternative techniques for external • Discuss controversies regarding
significant spinal injury in elderly cervical orthoses. Demonstrate, or describe in detail, diagnosis, management and prognosis of
patients on plain cervical xrays, CT the correct fitting of common cervical external chronic musculoligamentous spinal
scans and MRI scans of the cervical, orthoses, including the application of a halothoracic injuries (including "whiplash").
thoracic and lumbar regions brace.
• Demonstrate the correct technique
for cervical immobilization for an
emergency trauma endotracheal
intubation.
Neoplasia • Describe the clinical and radiological • Discuss the options of surgery and radiotherapy for • Discuss the indications for dorsal
features of intra-axial and extra- acute neoplastic spinal cord compression. decompression and ventral
axial spinal tumours affecting the • Discuss the diagnosis and management of primary decompression of acute neoplastic spinal
cervical, thoracic and lumbar spinal tumours, spinal cord tumours, and spinal cord compression at various levels.
regions. metastatic disease. • Discuss the options for spinal fixation of
• Discuss the appropriate radiological • Describe the most common types of spinal tumours in neoplastic disease.
investigations for patients with the following categories: • Discuss controversies regarding surgery
spinal neoplasia. o intradural/intramedullary; for intra-axial spinal tumours.
o intradural/extramedullary; • Discuss the controversies surrounding the
o extradural. extent of surgical vertebral column.
Infection • Discuss the pathogenesis and • Discuss the management principles for epidural • Discuss the management options for
bacteriological features of spinal abscess and discitis, and clearly described the infected post operative stabilisation

infections. indications/contra-indications for both surgical and procedures.

• Describe the clinical and radiological medical management.
features of discitis. • Discuss the factors contributing to post operative
• Describe the clinical and radiological spinal infections.
features of epidural abscess. • Describe the evidence for the use of prophylactic
antibiotic in spinal surgery.
Congenital and • Describe the normal embryological • Discuss the pathophysiology, clinical presentation • Discuss the pathological significance and
developmental development of the spine and spinal (signs & symptoms) and management options in the management options for Tarlov cysts and
cord. treatment of syringomyelia. spinal arachnoid cysts.
• Discuss the embryology and • Discuss the pathophysiology, clinical presentation • Describe in detail the surgical procedure
anatomy of major forms of spinal (signs & symptoms) and management options in the for closure of a neonatal
dysraphism. management of the adult tethered cord syndrome. myelomeningocoele.
• Describe the clinical features of • Describe the indications for spinal cord • Describe the management options for
spinal dysraphism presenting at detethering,and the surgical options available to do incontinence secondary to neonatal spinal
different ages (neonatal, childhood this. dysraphism.
and adulthood). • Describe the surgical and non-surgical
options available for the management of
chronic spasticity secondary to spinal
cord pathology.
Principles of spinal • Describe in detail the definition • Discuss the materials available for spinal fusion and • Discuss the properties of various grafting
fusion and spinal instability, and describe the describe the relative risk/benefit analysis of each. materials eg osteoconductive,
stabilisation various mechanisms causing this. • Compare and contrast the indications/contra- osteoinductive and osteogenic.
• Discuss the biology of bone healing. indications and techniques for anterior and posterior • Discuss additional measures to enhance
• Define the terms stabilisation, cervical spinal stabilisation. fusion.
instrumentation and fusion in • Compare and contrast the indications for anterior or • Discuss the controversies surrounding the
relation to spinal pathology. posterior lumbar interbody fusion and intertransverse role of fusion associated with discectomy
• Discuss the principles of bone fusion for lumbar disease. for radiculopathy in the cervical and
grafting in spinal surgery. • Discuss the indications and options for internal lumbar regions.
• Describe the general indications for fixation in association with lumbar fusion. • Describe the principles and techniques of
spinal stabilisation, and whether this • Discuss in detail the role of non-surgical management use of commonly use commercial spinal
requires fusion &/or instrumentation. of spinal instability in both acute (eg post-traumatic internal fixation systems available for the
or following surgical decompression) and chronic (eg different spinal regions (anterior and
degenerative) spinal instability in the cervical and posterior).
lumbar. • Discuss the literature regarding the
relative merits of arthrodesis versus
arthroplasty in the cervical and
lumbarspine.
Spinal vascular • Describe in detail the normal blood • Demonstrate the normal and abnormal anatomy • Demonstrate, or describe in detail
conditions supply and venous drainage of the demonstrated of spinal angiography for spinal AVM indications for and technical nuances of
spinal cord. and spinal dural AVF surgery for a spinal dural AVF.
• Describe the venous anatomy of the • Discuss the role of endovascular procedures in the • Demonstrate, or Describe in detail

spinal column management of spinal disorders. indications for and technical nuances of
• Describe the anatomy and clinical • Discuss the aetiology, presentation, diagnostic surgery for a spinal cord cavernoma
significance of the Artery of features and natural history of spinal cord cavernous • Describe in detail indications for and
Adamkiewicz haemangioma technical nuances in surgery for a spinal
• Describe the risks and indications of • Discuss the aetiology, presentation, classification and cord AVM.
spinal angiography. natural history of spinal cord arteriovenous
malformations (spinal AVM).
• Discuss the aetiology, presentation, classification and
natural history of spinal dural arteriovenous fistulae
(spinal dural AVF)
• Discuss the treatment options for spinal AVMs.
• Describe the clinical presentation, epidemiology,
radiological features, pathology and natural history of
vertebral haemangioma.

SYLLABUS MODULE – VASCULAR DISEASE
• Describe in detail the anatomy of • Discuss the use and limitations of nuclear • Discuss the uses and risks of
Stroke (excluding intracranial arteries and extracranial cervical medicine investigations in cerebral anticoagulation in the prevention and
subarachnoid arteries. ischaemia. treatment of cerebral ischaemia.
• Describe in detail the anatomy intracranial • Describe the aetiology, clinical • Discuss the uses and risks of antiplatelet
haemorrhage)
veins and extracranial cervical veins. presentations, natural history, therapy in the prevention and treatment of
• List the causes of cerebral ischaemia. histopathology and investigation of moya- cerebral ischaemia.
• Discuss the risk factors for occlusive moya syndromes. • Discuss the uses and risks of thrombolysis
cerebrovascular disease. • Describe the gross and microscopic in cerebral ischaemia.
• Describe the risk factors for thromboembolic pathology in arterial dissection. • Discuss in detail the role of angioplasty in
cerebrovascular disease. • Describe in detail the diagnostic studies to cerebral ischaemia.
• Discuss the clinicopathological effects of confirm arterial dissection. • Discuss the management options,
progressive cerebral ischaemia. • Discuss the management options of arterial complications and follow up of moya-moya
• Describe the clinical presentation of dissection. syndromes.
ischaemia to each of the major intracerebral • Describe the clinical syndromes associated • Describe the complications of management
vascular territories. with intracranial venous occlusion. of arterial dissection and explain the
• Describe the clinical syndrome of vertebral • Discuss in detail the investigations of reasons for long-term follow-up.
steal. intracranial venous occlusive disease. • Discuss the method and indications for
• Describe the vascular supply of the spinal • Discuss the long-term complications of endovascular management of venous
cord. intracranial venous occlusion. occlusive disease.
• Describe the clinical presentation of anterior • Discuss in detail the approaches to and • Discuss in detail controversies surrounding
and posterior spinal territory ischaemia. techniques of evacuation of spontaneous surgery for spontaneous intracerebral
• Discuss the use and limitations of CT scan intracerebral haemorrhage. haemorrhage.
and MRI in cerebral ischaemia. • Discuss gross and microscopic pathology of • Discuss the evidence for the role of
• Discuss the use and risks of angiography in intracerebral haemorrhage eg Amyloid. specialist stroke units and rehabilitation
cerebral ischaemia. units.
• Describe the mechanisms of thrombus
formation and dissolution.
• Describe the techniques, uses and
limitations of doppler sonation in cerebral
vascular disease.
• Discuss the prothrombotic disorders.
• Discuss the aetiology, clinical presentation
and natural history of arterial dissection.
• List the investigations of suspected arterial

dissection.
• Discuss risk factors, medical management
and prognosis of brain haemorrhage.
• Discuss the common sites of spontaneous
intracerebral haemorrhage and their likely
causes.
Extracranial • Describe the risk factors for atheromatous • Discuss the investigation and management
vascular disease carotid disease. options for TIA.
• Discuss the clinical diagnosis, differential • Discuss the natural history of asymptomatic
diagnosis and significance of transient and symptomatic carotid stenosis.
ischaemic attack (TIA). • Discuss the indications, risks and benefits of
• List the treatment options for carotid carotid endarterectomy.
stenosis. • Discuss the management of complications
• Describe the perioperative management of of carotid endarterectomy.
carotid endarterectomy. • Discuss the indications, risks and benefits of
• Describe the perioperative management of carotid stenting.
stent deployment. • Discuss the management of complications
• of carotid stenting.
• Demonstrate the surgical exposure of
carotid bifurcation, protecting the cranial
nerves.
• Discuss the natural history of acute arterial
sacrifice.
• Discuss methods of assessing risk of acute
arterial sacrifice.
• Demonstrate microsurgical anastomotic
suturing techniques in laboratory.
• Demonstrate harvesting vein or artery for
use in bypass.
Aneurysms and non- • Describe in detail the clinical and • Discuss the systemic effects of non-
traumatic radiological grading systems of traumatic subarachnoid haemorrhage.
subarachnoid subarachnoid haemorrhage. • Describe in detail the management of the
• Discuss the aetiology, clinical presentation complications of subarachnoid haemorrhage
haemorrhage
and natural history of non-traumatic including vasospasm and hydrocephalus.
subarachnoid haemorrhage. • Describe the histopathology of intracranial
• List the investigations of a patient with aneurysms.
presumed non-traumatic subarachnoid • Discuss the influence of site, size, shape,
haemorrhage. age, environment and hereditary factors in
• Define the features on CT of subarachnoid natural history of intracranial aneurysms.
haemorrhage. • Discuss the outcome and natural history of

• Describe the early management of non- symptomatic unruptured intracranial

traumatic subarachnoid haemorrhage. aneurysms.
• Describe the outcome of intracranial • Discuss the endovascular and surgical role
aneurysm rupture. for aneurysm treatment.
• Discuss the risks associated with surgical • Discuss the role of non-interventional
and endovascular treatment of aneurysm management of intracranial aneurysms.
treatment (for obtaining informed consent). • Discuss the investigation of a patient with
• Discuss the aetiology, common sites, clinical mycotic aneurysms.
presentation and natural history of
traumatic aneurysms.
• Discuss the aetiology, microbiology,
common sites, clinical presentation and
natural history of mycotic aneurysms.
Cerebral AVMs • Discuss the epidemiology, aetiology and • Discuss haemodynamics of brain AVMs.
gross pathology of brain AVMs. • Describe the microscopic pathology of
• Discuss the spectrum of presentation of cerebral AVMs.
cerebral AVMs. • Discuss the natural history of AVMs.
• Discuss the risk of haemorrhage from an
AVM including the impact of angiographic
factors, demographic and clinical factors.
• Describe the grading scales for cerebral
AVMs and the risks of surgical treatment.
• Describe the non-interventional
management of AVMs.
• Discuss perioperative management of
cerebral AVMs.
• Discuss the aetiology, presentation,

Spinal AVMs classification and natural history of spinal
AVMs.
Cavernous angioma • List the angiographically occult vascular • Discuss the gross and microscopic
malformations. pathology of angiographically occult
• Discuss the clinical presentation of vascular malformations.
angiographically occult vascular • Discuss the radiological findings in
malformations. angiographically occult vascular
malformations


Neurosurgery Syllabus - Australasia

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Curriculum - Syllabus Modules

Surgical Education and Training in Neurosurgery

SYLLABUS MODULE – CLINICAL NEUROLOGY

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

Updated January 2014

patients suffering seizures. • Describe the different types of epilepsy

Updated January 2014

Updated January 2014

SYLLABUS MODULE – INFECTION

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

Updated January 2014

SYLLABUS MODULE – NEUROANAESTHESIA

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

Updated January 2014

Updated January 2014

SYLLABUS MODULE – NEUROANATOMY

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

Updated January 2014

Updated January 2014

• Describe in detail the anatomy of the

Updated January 2014

Updated January 2014

Updated January 2014

Updated January 2014

lumbosacral plexus and its branches

Updated January 2014

SYLLABUS MODULE – NEURO-ONCOLOGY

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

Updated January 2014

invasion and tumour biology on the

Updated January 2014

particular, glucocorticoids and

Updated January 2014

and diagnostic criteria used to with them. with neurofibromatosis.

Updated January 2014

controversial adjuvant therapies for

Updated January 2014

Updated January 2014

Updated January 2014

with CPA tumours. • Discuss strategies of hearing preservation

Updated January 2014

patients who have had pituitary

Updated January 2014

Updated January 2014

Updated January 2014

• Discuss drug delivery to the central

SYLLABUS MODULE – NEURO-OPHTHALMOLOGY

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

Updated January 2014

SYLLABUS MODULE – NEURO-OTOLOGY

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

• Describe in detail the anatomy of the • Interpret audiometric evaluation - pure-tone

• Describe the pathophysiology of • Discuss cholesteatoma • Describe the intracranial complications

Updated January 2014

SYLLABUS MODULE – NEUROPATHOLOGY

Basic Learning Outcomes Intermediate Learning Outcomes Advanced Learning Outcomes

Updated January 2014

types of cerebral aneurysms.

Updated January 2014

as it relates to the mechanism of • Describe long term pathological changes following