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Neurosurgery

Neurosurgeon
Parkinson surgery.jpg
Insertion of an electrode during neurosurgery for Parkinson's disease.
Occupation
Names Doctor, Medical Specialist, Surgeon
Type Surgery
Activity sectors Surgery
Description
Education required Doctor of Medicine
Fields of employment Hospitals, Clinics

Neurosurgery (or Neurological Surgery) is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.[1][2]

Contents

[edit] History

Brain surgery is perhaps the oldest of the medical practices. Africa showed evidence of brain surgery as early as 3,000 B.C. Pre-Incan civilization used brain surgery as early as 2,000 B.C. [3]

[edit] Education and Training

In the United States, a neurosurgeon must generally complete four years of college, four years of medical school, a year-long internship (PGY-1) that is usually affiliated with their residency program, and five to six years of neurosurgery residency (PGY-2-6)[4]. Most, but not all, residency programs have some component of basic science or clinical research. Neurosurgeons may pursue an additional training in a fellowship, after residency or in some cases, as a senior resident. These fellowships include pediatric neurosurgery, neurocritical care, functional and stereotactic surgery, surgical neuro-oncology, neurovascular surgery, Interventional neuroradiology, or skull base surgery.[5]

[edit] Neurosurgical Methods

Neuroradiogy methods are used in modern neurosurgical diagnosis and treatment. 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 involve the use of MRI and functional MRI intraoperatively.

Microsurgery is utilized in many aspects of neurological surgery. Microvascular anastomosis are required when EC-IC surgery is performed. The clipping of aneurysms is performed using a microscope. Minimally invasive spine surgery utilizes relies on these techniques. Procedures such as microdiscectomy, laminectomy, and artificial discs rely on microsurgery. [6]

Minimally invasive endoscopic surgery is utilized by neurosurgeons. Techniques such as endoscopic endonasal surgery is used for pituitary tumors, craniopharyngiomas, chordomas, and the repair of cerebrospinal fluid leaks. Ventricular endoscopy is used for colloid cysts and neurocysticercosis. Endoscopic techniques can be used to assist in the evaculation of hematomas and trigeminal neuralgia. Repair of craniofacial disorders and disturbance of cerebrospinal fluid circulation is done by neurosurgeons, and depending on the situation, plastic surgeons. Conditions such as chiari malformation, craniosynostosis, and syringomyelia are treated. This is called cranioplasty.

Neurosurgeons are involved in Stereotactic Radiosurgery along with Radiation Oncologists for tumor and AVM treatment. Radiosurgical methods such as Gamma knife and Cyberknife are used. [7]

Neurosurgeons have began to utilize endovascular image guided procedures for the treatment of aneurysms, AVMs, carotid stenosis, strokes, and spinal malformations, and vasospasms. Also, nonvascular procedures such as Vertoplasty and Kyphoplasty are used by neurosurgeons. Techniques such as angioplasty, stenting, clot retrieval, embolization, and diagnostic angiography are utilized. [8]

[edit] Conditions

Other conditions treated by neurosurgeons include:

[edit] See also

[edit] References



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