Neurosurgery is the
surgerySurgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, or sometimes for some other reason...
discipline focused on treating the
central nervous systemThe central nervous system is the part of the nervous system that functions to coordinate the activity of all parts of the bodies of bilaterian animals—that is, all animals more advanced than sponges or jellyfish. In vertebrates, the central nervous system is enclosed in the meninges. It contains...
,
peripheral nervous systemThe peripheral nervous system resides or extends outside the central nervous system , which consists of the brain and spinal cord. The main function of the PNS is to connect the CNS to the limbs and organs. Unlike the central nervous system, the PNS is not protected by bone or by the blood-brain...
s and
spinal columnThe spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain. The brain and spinal cord together make up the central nervous system. It is around 45 cm long in men and around 43 cm long in women. The length of the spinal cord is much shorter than...
diseases amenable to surgical intervention.
Neurosurgery generally has the longest training period of all the medical specialties; the neurosurgeon (at least in America) must complete the eight years of pre-medical and medical education, a one year-long surgical internship (where this is not a part of the residency), and five to seven years of neurosurgery
residencyResidency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree and who practices medicine under the supervision of fully licensed physicians, usually in a hospital or clinic...
.
Neurosurgery is the
surgerySurgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, or sometimes for some other reason...
discipline focused on treating the
central nervous systemThe central nervous system is the part of the nervous system that functions to coordinate the activity of all parts of the bodies of bilaterian animals—that is, all animals more advanced than sponges or jellyfish. In vertebrates, the central nervous system is enclosed in the meninges. It contains...
,
peripheral nervous systemThe peripheral nervous system resides or extends outside the central nervous system , which consists of the brain and spinal cord. The main function of the PNS is to connect the CNS to the limbs and organs. Unlike the central nervous system, the PNS is not protected by bone or by the blood-brain...
s and
spinal columnThe spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain. The brain and spinal cord together make up the central nervous system. It is around 45 cm long in men and around 43 cm long in women. The length of the spinal cord is much shorter than...
diseases amenable to surgical intervention.
Neurosurgery generally has the longest training period of all the medical specialties; the neurosurgeon (at least in America) must complete the eight years of pre-medical and medical education, a one year-long surgical internship (where this is not a part of the residency), and five to seven years of neurosurgery
residencyResidency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree and who practices medicine under the supervision of fully licensed physicians, usually in a hospital or clinic...
. Many neurosurgeons pursue an additional one to three years of training in a subspecialty fellowship (like pediatric neurosurgery,
epilepsyEpilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures...
,
tremorA tremor is an unintentional, somewhat rhythmic, muscle movement involving to-and-fro movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, head, face, vocal cords, trunk, and legs. Most tremors occur in the hands. In some people,...
, or stroke ("functional") neurosurgery, microneurosurgery, endovascular or open vascular neurosurgery, or neuro-oncological surgery).
Modern Neurosurgery
Modern neurosurgery has benefited greatly from advances in microsurgery, computer assisted imaging computed tomography (CT), magnetic resonance imaging (MRI),
positron emission tomography (PET)Positron emission tomography is a nuclear medicine imaging technique which produces a three-dimensional image or picture of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide , which is introduced into the body on a...
,
magnetoencephalography (MEG)Magnetoencephalography is an imaging technique used to measure the magnetic fields produced by electrical activity in the brain via extremely sensitive devices such as superconducting quantum interference devices . These measurements are commonly used in both research and clinical settings...
and the development of
stereotactic surgeryStereotactic surgery or stereotaxy is a minimally-invasive form of surgical intervention which makes use of a three-dimensional coordinates system to locate small targets inside the body and to perform on them some action such as ablation , biopsy, lesion, injection, stimulation, implantation,...
. Some neurosurgical procedures even involve the use of MRI and functional MRI intraoperatively. As one of the most research-oriented specialties of medicine, the scope of neurosurgery has expanded as new diagnostic techniques allow surgeons to perform more complicated surgeries. Some of the most recent and innovative advances have been radiosurgery using the
Gamma knifeA gamma knife is a device used to treat brain tumors with a high dose of radiation therapy in one day. The device was invented at the Karolinska Institute in 1967 by Lars Leksell, a Swedish neurosurgeon....
and
CyberknifeThe CyberKnife is a frameless robotic radiosurgery system invented by John R. Adler a Stanford University Professor of Neurosurgery and Radiation Oncology and Peter and Russell Schonberg of Schonberg Research Corporation, The two main elements of the CyberKnife are the radiation produced from a...
for
tumorA tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells . Tumor is not synonymous with cancer. A tumor can be benign, pre-malignant or malignant, whereas cancer is by definition malignant....
treatment and endovascular surgery for the treatment of
aneurysmAn aneurysm or aneurism , is a localized, blood-filled dilation of a blood vessel caused by disease or weakening of the vessel wall....
s.
Risks
There are many risks to neurosurgery. Any operation dealing with the brain or spinal cord can cause
paralysisParalysis is the complete loss of muscle function for one or more muscle groups. Paralysis can cause loss of feeling or loss of mobility in the affected area.-Causes:Paralysis is most often caused by damage to the nervous system, especially the spinal cord...
(systemic), brain damage,
infectionAn infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host's resources to multiply, usually at the expense of the host. The infecting organism, or pathogen, interferes with the normal functioning of the...
,
psychosisPsychosis literally means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
or death. However, before neurosurgery is performed, neuroimaging tests (CAT, MRI, PET) and a comprehensive physical and psychological examination are generally done that can help to minimize the risk of serious impairment, paralysis, or death.
Conditions
Neurosurgical conditions include primarily
brainThe brain is the center of the nervous system in all vertebrate, and most invertebrate, animals. Some primitive animals such as jellyfish and starfish have a decentralized nervous system without a brain, while sponges lack any nervous system at all...
, spinal cord, vertebral column and peripheral nervous system disorders.
Conditions treated by neurosurgeons include:
- Chiari Malformations
- Spinal disc herniation
A spinal disc herniation , informally and misleadingly called a "slipped disc", is a medical condition affecting the spine, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out...
- Spinal stenosis
Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves. This is usually due to the common occurrence of spinal degeneration that occurs with aging. It can also sometimes be caused by spinal disc herniation, osteoporosis or a tumor...
- Hydrocephalus
Hydrocephalus , also known as "water on the brain", is a medical condition. People with hydrocephalus have an abnormal accumulation of cerebrospinal fluid in the ventricles, or cavities, of the brain. This may cause increased intracranial pressure inside the skull and progressive enlargement of...
- Head trauma (brain hemorrhages, skull fractures, etc.)
- Spinal cord
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain. The brain and spinal cord together make up the central nervous system. It is around 45 cm long in men and around 43 cm long in women. The length of the spinal cord is much shorter than...
traumaPhysical trauma refers to a physical injury, generally of a considerably severe degree. A trauma patient is someone who has suffered serious and life-threatening physical injury with the potential for secondary complications such as shock, respiratory failure and death.-Common causes:Comprehensive...
- Traumatic injuries
Physical trauma refers to a physical injury, generally of a considerably severe degree. A trauma patient is someone who has suffered serious and life-threatening physical injury with the potential for secondary complications such as shock, respiratory failure and death.-Common causes:Comprehensive...
of peripheral nervesThe peripheral nervous system resides or extends outside the central nervous system , which consists of the brain and spinal cord. The main function of the PNS is to connect the CNS to the limbs and organs. Unlike the central nervous system, the PNS is not protected by bone or by the blood-brain...
- Brain tumor
A brain tumor is an abnormal growth of cells within the brain or inside the skull, which can be cancerous or non-cancerous .It is defined as any intracranial tumor created by abnormal and uncontrolled cell division, normally either in the brain itself , in the cranial nerves...
s
- Infections and infestations
- Tumours of the spine, spinal cord
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain. The brain and spinal cord together make up the central nervous system. It is around 45 cm long in men and around 43 cm long in women. The length of the spinal cord is much shorter than...
and peripheral nervesThe peripheral nervous system resides or extends outside the central nervous system , which consists of the brain and spinal cord. The main function of the PNS is to connect the CNS to the limbs and organs. Unlike the central nervous system, the PNS is not protected by bone or by the blood-brain...
- Cerebral aneurysm
A cerebral aneurysm or brain aneurysm is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.- Locations :...
s
- Stroke
A stroke is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by thrombosis or embolism or due to a hemorrhage...
, including hemorrhagic strokeA stroke is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by thrombosis or embolism or due to a hemorrhage...
and stroke
- Intracerebral hemorrhage, such as subarachnoid hemorrhage
A subarachnoid hemorrhage is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain...
, intraparenchymal, and intraventricular hemorrhages
- Some forms of drug-resistant epilepsy
Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures...
- Some forms of movement disorder
Movement disorders include:* Akathisia* Akinesia * Associated Movements * Athetosis * Ataxia...
s (advanced Parkinson's diseaseParkinson's disease is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills, speech, and other functions....
, chorea) this involves the use of specially developed minimally invasive stereotacticStereotaxy from stereo meaning solidity, and tactile meaning touch) refers to any technique that involves the recording and reproduction of three-dimensional haptic information or creating an illusion of depth to the sense of touch within an otherwise-flat surface...
techniques (functional, stereotactic neurosurgery) such as ablative surgery and deep brain stimulationDeep brain stimulation is a surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain...
surgery
- Intractable pain of cancer
Cancer is a class of diseases in which a group of cells display uncontrolled growth , invasion , and sometimes metastasis...
or traumaTrauma can represent:-Psychological and medical:* Physical trauma, an often serious and body-altering physical injury, such as the removal of a limb...
patients and cranial/peripheral nerve pain
- Some forms of intractable psychiatric disorders
- Malformations of the nervous system
The nervous system is a network of specialized cells that communicate information about an organism's surroundings and itself. It processes this information and causes reactions in other parts of the body. It is composed of neurons and other specialized cells called glial cells that aid in the...
- Carotid artery stenosis
Carotid stenosis is a narrowing or constriction of the inner surface of the carotid artery, usually caused by atherosclerosis .The carotid artery is the large artery whose pulse can be felt on both sides of the neck under the jaw. It starts from the aorta as the common carotid artery, and at the...
- Vascular malformations (i.e., arteriovenous malformation
Arteriovenous malformation or AVM is an abnormal connection between veins and arteries, usually congenital. This pathology is widely known because of its occurrence in the central nervous system, but can appear in any location....
s, venous angiomas, cavernous angiomaCavernous angioma, also known as cerebral cavernous malformation , cavernous haemangioma, and cavernoma, is a vascular disorder of the central nervous system that may appear either sporadically or exhibit autosomal dominant inheritance....
s, capillary telangectasias) of the brain and spinal cord
- Peripheral neuropathies
Neuropathy is a medical term referring to disorders of the nerves of the peripheral nervous system It is usually considered equivalent to peripheral neuropathy, which is defined as deranged function and structure of peripheral motor, sensory, and autonomic neurons, involving either...
such as carpal tunnel syndromeCarpal tunnel syndrome , or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist, leading to paresthesias, numbness and muscle weakness in the hand. Night symptoms and waking at night is a characteristic of established carpal tunnel syndrome...
and ulnar neuropathy
- Moyamoya disease
- Congenital malformations of the nervous system, including spina bifida
Spina bifida is a developmental birth defect caused by the incomplete closure of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to stick out through the...
and craniosynostosisCraniosynostosis, is a medical condition in which some or all of the sutures in the skull of an infant or child close too early, causing problems with normal brain and skull growth. It can result in craniostenosis, which is the skull deformity caused by the premature closure of the cranial sutures...
See also
- Harvey Cushing
Harvey Williams Cushing, M.D. was an American neurosurgeon and a pioneer of brain surgery. He is widely regarded as the greatest neurosurgeon of the 20th century and often called the "father of modern neurosurgery".-Life:...
Known as the father of neurosurgery
- Gazi Yasargil
Mahmut Gazi Yaşargil is a Turkish medical scientist and neurosurgeon . He is the founder of microneurosurgery. Yaşargil treated epilepsy and brain tumors with instruments of his own design...
Known as the father of modern microneurosurgery
- Wilder Penfield
Wilder Graves Penfield, OM, CC, CMG, FRS was an American born Canadian neurosurgeon. During his life he was called "the greatest living Canadian"...
Known as one of the founding fathers of neurosurgery
- Walter Dandy
Walter Edward Dandy was an American neurosurgeon and scientist. He is considered one of the founding fathers of neurosurgery, and is credited with numerous discoveries and innovations, including the description of the circulation of cerebrospinal fluid in the brain, surgical treatment of...
Known as one of the founding fathers of neurosurgery
- Brian Andrews (doctor)
Dr. Brian T. Andrews is a neurosurgeon specializing in , minimally invasive spinal surgery, brain tumors, neuro-oncology, neurotrauma, spinal stenosis and general neurosurgery...
Noted American Neurosurgeon
- Ben Carson
Dr. Benjamin S. Carson, Sr, M.D.. is an American neurosurgeon and the Director of Pediatric Neurosurgery at Johns Hopkins Hospital. He was awarded the Presidential Medal of Freedom in 2008.-Background and education:...
Famous African American Neurosurgeon
- Anton Eiselsberg
Anton Freiherr von Eiselsberg was born on July 31, 1860 at castle Schloss Steinhaus, Upper Austria.A student of Theodor Billroth, Eiselsberg served as professor of medicine at Utrecht University and at University of Königsberg before being appointed head of the First Department of Surgery at the...
Established Neurosurgery as an independent discipline
- Sid Watkins
Eric Sidney Watkins OBE , FRCS is a world-renowned English neurosurgeon.Watkins served twenty-six years as the FIA Formula One Safety and Medical Delegate, head of the Formula One on-track medical team, and first responder in case of a crash.He is commonly known within the Formula One fraternity...
World renowned neurosurgeon who served for 26 years as the Formula OneFormula One, also known as Formula 1 or F1, and currently officially referred to as the FIA Formula One World Championship, is the highest class of auto racing sanctioned by the Fédération Internationale de l'Automobile . The "formula" in the name refers to a set of rules to which all participants...
Safety and Medical Delegate (race doctor)
- Lars Leksell
Lars Leksell was a Swedish physician and Professor of Neurosurgery at the Karolinska Institute in Stockholm, Sweden. He was the inventor of radiosurgery.-Life and work:...
Swedish Neurosurgeon who developed the Gamma KnifeA gamma knife is a device used to treat brain tumors with a high dose of radiation therapy in one day. The device was invented at the Karolinska Institute in 1967 by Lars Leksell, a Swedish neurosurgeon....
- Frances K. Conley
Frances K. Conley is a professor of neurosurgery at Stanford University. She is the author of Walking Out on the Boys , the story of her protest of misogyny at the University hospital....
Pioneer woman neurosurgeon at Stanford UniversityThe Leland Stanford Junior University, commonly referred to as Stanford University or Stanford, is a private research university located in Stanford, California, United States...
- Congress of Neurological Surgeons
The Congress of Neurological Surgeons is a professional body representing neurosurgeons, neurosurgical residents, medical students, and allied health professionals...