What is neurosurgery?
Neurosurgery is a medical speciality, which deals with diagnosing and treating diseases resulting from injury of the brain, spinal cord, vertebral column and peripheral nerves. The neurosurgeon can provide surgical or conservative treatment, depending on the nature of the disease or injury.
What sort of diseases do neurosurgeons treat?
Neurosurgeons are more than only brain surgeons. This medical specialists are educated in such a way to be able to help patients with head or spine traumas, brain vascular pathologies, for example, brain vessel aneurysm, brain hemorrhages or vessel thrombi, which can cause strokes, as well as head (facial) and back pain and tumors.
Brain, spine and nerve disorders, which the neurosurgeon usually treats, may include the following diseases:
- Brain and spinal cord neurosurgical pathologies in both adults and children;
- Malignant tumors of brain, spinal cord and periferal nerves;
- Benign tumors – meningiomas, epidermoids, dermoids, hemangioblastomas, colloid cysts, subependymal giant cell astrocytomas, pituitary adenomas, craniopharyngiomas, vestibular neuromas, abscesses, etc.;
- Neurovascular surgery – brain and spinal cord arteriovenous malformations, aneurysms, hemorrhages, vascular stenoses, thromboses, etc.;
- Spinal neurosurgery – discogenic radiculitis, spinal cord compression, spinal canal stenoses and discitis;
- Peripheral nerve surgery – compression neuropathies (carpal tunnel and other syndromes), traumatic nerve injury;
- Functional and stereotactic neurosurgery – trigeminal and glossopharyngeal neuralgies, hemifacial spasm, epilepsy, Parkinson disease, tremor, chronic pain syndrome, etc.;
- Brain and spine traumas – including severe brain damage (cerebral coma), intracranial pressure monitoring, spinal fracture correction with spinal cord decompression, etc.
How are neurosurgeons educated?
Upon successfully completing medical higher studies, the future specialist enrolls in a postgraduate 6-year neurosurgery residency program. During residency, the future neurosurgeons are taught all neurosurgical aspects, including cerebrovascular, pediatric, and spinal traumatic disorders and tumors. The residency program is long and difficult, because the nervous system is extremely complicated, and during surgery the most modern equipment and technology is utilized. Following residency, many neurosurgeons choose to perform additional studies in a special medical field. Upon finishing residency, neurosurgeons are required to pass an exam in order to judge their comprehensive skills and assess their knowledge detail. Upon successfully passing the exam, they would receive the Latvian Medical Assiciation certificate, which enables them to practice independently (in other EU countries as well).
Regardless of the fact that neurosurgeons, upon finishing the residency program, have a broad and comprehensive knowledge, constant changes occur in the neurosurgery profession, requiring the improvement of knowledge and performing scientific researches throughout the neurosurgical professional career. Monthly scientific journals, annual meetings, specialized seminars, conferences and other educational possibilities help the neurosurgeon be aware of rapid changes and progress in neurosurgery.What is the role of the neurosurgeon?
Neurosurgeons provide surgical and non-surgical neurological deficit care (prophylaxis, diagnostics, assessment, treatment, critical care and rehabilitation). Taking into account that neurosurgeons have a broad and comprehensive knowledge in neurosurgical diseases, they are frequently invited to consult by emergency medicine doctors, neurologists, internists, osteopathologists, general practitioners and other doctors.
What is new in neurosurgery?
Regardless of the fact that neurosurgery is a surgical field, many patients are treated more preservingly – by minimally invasive or even conservative methods. Minimally invasive surgery equipment and technology rapid development – e.g. operation microscope innovations, neuronavigation, neuroendoscopy, stereotaxy, laser, focus-radiation, stereotactic radiosurgery, microsurgical instruments, stents, vertebral cementing and stabilization – change the way of treating neurological diseases. Medicine’s rapid development require neurosurgeons to know the fine technological nuances (to “walk as if on a knife’s edge”) and increase the neurosurgeon’s ability to care for the patients, as well as make the operations more tolerable to them.
Figure- Cranial fracture
Figure- Blood between brain’s solid membrane and bone (epidural hematoma)
Figure- Liquid between brain and solid membrane – blood (chronic subdural hematoma)
Figure- DT (left) Specific vertebra inflammation with spinal canal compression
Figure- Liquid in lower part of lumbar vertebra spinal canal (epidural abscess)
Figure- Vertebra obstructed hernia and spinal canal stenosis
Figure- Aneurysm of cerebral artery with brain hematoma
Figure- Aneurysm of medial brain artery
Figure- Digital subtraction on angiography – aneurysm is operated (clipped)
Figure- Big tumor of brain (meningioma)
Figure- Tumor of brain (meningioma) visible into the operation area
Figure- Meningioma is operated (resection)
Figure- Resection of small cavernous angioma using neuronavigation