Neurosurgery

Neurosurgery is the surgery discipline focused on treating the central nervous system and peripheral nervous systems and spinal column diseases amenable to surgical intervention. Neurosurgery deals with the study and practice of surgery in diseases of central and peripheral nervous systems. Neurological surgery 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, the yearlong surgical internship (where this is not a part of the residency), and five to seven years of neurosurgery residency. Many neurosurgeons pursue a further one to three years of training in a subspecialty fellowship (which could be in pediatric neurosurgery, epilepsy, tremor, 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), magnetoencephalography (MEG) and the development of stereotactic surgery. 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 knife and Cyberknifefor tumor treatment and endovascular surgery for the treatment of aneurysms.

Risks

There are many risks to neurosurgery. Any operation dealing with the brain or spinal cord can cause paralysis (systemic), brain damage, infection, psychosis 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 brain, spinal cord, vertebral column and peripheral nerve disorders.

Conditions treated by neurosurgeons include:

• Chiari Malformations
• Spinal disc herniation
• Spinal stenosis
• Hydrocephalus
• Head trauma (brain hemorrhages, skull fractures, etc.)
• Spinal cord trauma
• Traumatic injuries of peripheral nerves
• Brain tumors
• Infections and infestations
• Tumours of the spine, spinal cord and peripheral nerves
• Cerebral aneurysms
• Stroke, including hemorrhagic stroke and ischemic stroke
• Intracerebral hemorrhage, such as subarachnoid hemorrhage, intraparenchymal, and intraventricular hemorrhages
• Some forms of pharmacologically resistant epilepsy
• Some forms of movement disorders (advanced Parkinson's disease, chorea)– this involves the use of specially developed minimally invasive stereotactic techniques (functional, stereotactic neurosurgery) such as ablative surgery and deep brain stimulation surgery
• Intractable pain of cancer or trauma patients and cranial/peripheral nerve pain
• Some forms of intractable psychiatric disorders
• Malformations of the nervous system
• Carotid artery stenosis
• Vascular malformations (i.e., arteriovenous malformations, venous angiomas, cavernous angiomas, capillary telangectasias) of the brain and spinal cord
• Peripheral neuropathies such as carpal tunnel syndrome and ulnar neuropathy
• Moyamoya disease
• Congenital malformations of the nervous system, including spina bifida and craniosynostosis

See also

• Anton Eiselsberg– Established Neurosurgery as an independent discipline
• Harvey Cushing– Known as the father of neurosurgery
• Wilder Penfield– Known as one of the founding fathers of neurosurgery
• Walter Dandy– Known as one of the founding fathers of neurosurgery
• Gazi Yasargil– Known as the father of modern microneurosurgery
• Ben Carson– Famous African American Neurosurgeon
• Sid Watkins– World renowned neurosurgeon who served for 26 years as the Formula One Safety and Medical Delegate (race doctor)
• Brian Andrews (doctor) – Noted American Neurosurgeon
• Lars Leksell– Swedish Neurosurgeon who developed the Gamma Knife
• Frances K. Conley –Pioneer woman neurosurgeon at Stanford University
• Congress of Neurological Surgeons