About

Neurosurgery

Neurosurgery is the branch of medicine which diagnoses, treats, and performs surgery for abnormalities of the brain, spine, nerves, and their blood vessels. The neurosurgeon differs from the neurologist in that he is trained to operate.

The scope of neurosurgery is broad, and includes: trauma to the skull, brain, nerves, or spine; tumors of those structures including pituitary and skull base tumors; strokes caused by vessel closure (carotid artery stenosis), hemorrhage, blood clot, or aneurysm in the head or neck; disorders of spine including radiculopathy (pinched nerves) commonly due to disc herniation or bony spur, and spinal instability and movement disorders; abnormal circulation of spinal fluid (hydrocephalus), surgical control of seizures or movement disorders (tremors); control of infections of the nervous system; correction of brain and spine birth defects; and surgical management of severe pain.

The training of the neurosurgeon is rigorous. After four years of college and five years of medical school and internship, the doctor undertakes 5-7 years of specialized training in diagnosis of diseases and surgery of the brain, spinal cord, blood vessels and nerves.

After 2 years of clinical practice, the neurosurgeon submits to a review by a senior panel of neurosurgeons in order to become "board certified". It is this training and experience, which uniquely qualifies the neurosurgeon to consult with the family practitioner, internist, pediatrician, neurologist, orthopedic surgeon, and psychiatrist to determine the exact nature of the patient's neurological problem and treatment.

Although the neurosurgeon's primary role is to perform surgery for these afflictions, perhaps an even more important function is his or her knowledge of when not to operate but to apply medical treatment instead. No one is served by ill-advised surgery, no matter how delicately done. Nervous tissue is delicate, intricate, and heals at a very slow pace. The neurosurgeon educates the patient concerning the disease process, risks of management, alternative treatments, and probable disability or improvement. The patient and the neurosurgeon must form a close understanding for good decision making. If there is doubt or misunderstanding, a second opinion from another neurosurgeon should be obtained.