Neurosurgeon

A neurosurgeon is a specialist responsible for the diagnosis and treatment of diseases, injuries and disorders in the central and peripheral nervous system, for example, CNS complications caused by spinal injuries, birth defects and pathologies, neurooncological diseases. Treatment in this case is in the nature of surgery.

Although neurosurgery as an independent branch of surgery was singled out only at the beginning of the 20th century, its history goes back much longer. Neurosurgeons who carry out their activities today use the achievements of their predecessors, collected over the past 5-6 centuries. However, even during the time of the ancient Incas, operations related to intervention in the cranium were practiced.

Throughout its existence, this specialization of surgery has gone from craniotomy with a chisel, hammer or Gigli’s wire saw, to unique micro-instruments for operations and innovative methods for examining patients such as x-rays and, much later, neuroimaging methods for studying diseases.

The names of Berengario da Carpi, Ambroise Pare, Thomas Willis, Nikolai Ivanovich Pirogov, Charles Ballance, Francesco Durante, Dmitry Nikolaevich Zernov, Lev Alexandrovich Malinovsky, Ludwig Martynovich Puusepp, Harvey Cushing, Walter Dandy remain fundamental in the history of the development of neurosurgery.

Competence of a neurosurgeon: what does a specialist do and what organs does he treat?

Having got an appointment with a doctor of this specialization, the patient, first of all, undergoes a thorough examination. The neurosurgeon examines the patient’s complaints, the external manifestations of the disease, and, if necessary, prescribes additional examinations. In addition to a comprehensive examination, the doctor consults patients on all issues related to their condition, conducts preoperative preparation of the patient, directly performs neurosurgical operations with the participation of other specialists, for example, an anesthesiologist, resuscitator.

In addition, the neurosurgeon is also responsible for the postoperative condition of the patient, determines and prescribes rehabilitation measures, as well as a conservative treatment regimen.

The organs and parts of the body treated by a neurosurgeon are:

• cranium;
• brain;
• spine.

In addition, the doctor is competent in matters of diseases of the nervous system requiring surgical intervention.

For the treatment of problems and pathologies of the nervous system and brain in children, patients are usually seen by a pediatric neurosurgeon.

Diseases, processes and pathologies that a neurosurgeon fights

Among all functional disorders in the human body, a neurosurgeon specialist has to deal with some of the most dangerous ones that can not only complicate a person’s life or make him disabled, but also threaten a fatal outcome in certain, especially acute cases. Among the diagnoses treated by this doctor:

• tumors of the spinal cord and brain, peripheral nerve trunks: these progressive cellular neoplasms destroy or compress the medulla, resulting in various disturbances in the functioning of the body. The disease is dangerous because it develops almost imperceptibly for the patient himself, and at those stages when it begins to manifest itself, the probability of its successful cure is greatly reduced;
• anomalies in the development of the nervous system: defects that manifest themselves in the development of the spine, skull, spinal cord or brain can occur against the background of injuries, intrauterine infections in infants, intoxication and other provoking factors;
• abscesses, hematomas and empyema of the brain: organ damage that occurs as a result of trauma, infection and the development of the inflammatory process;
• hemorrhagic and ischemic stroke, intracranial hemorrhage: acute violation of cerebral circulation as a result of blockage of the vessel or breakthrough of the integrity of the vessel and hemorrhage in the brain;
• tunnel syndrome: pinched nerve on the periphery in a narrow musculoskeletal space;
• osteochondrosis of the spine: damage to the cartilage and intervertebral discs, due to which the metabolism and blood circulation in the spine are disturbed;
• injuries of the brain and spinal cord, as well as peripheral nerves;
• tumors of the visual organs;
• herniated discs, spinal hematomas, plexopathies, trigeminal neuralgia, and other pathologies.

Symptoms and manifestations that indicate the need to visit a doctor

Often, alas, a person does not pay attention to minor changes in well-being, signaling possible disorders in the functioning of the nervous system or spine. The most common sensations that should be the reason for contacting a neurosurgeon:

• numbness of fingers and limbs;
• feeling of coldness in the fingers;
• chronic or systematic pain attacks in the spine, sternum, ribs;
• prolonged (more than 2-3 months) discomfort in the lower back.

The listed sensations and syndromes can disturb a person for a long time, but, due to their lack of expression, they do not always make it clear that a specialist consultation is needed.

More “eloquent” symptoms, when it is absolutely impossible to postpone going to the doctor:

• severe pain and numbness of the extremities with suspected herniated discs;
• persistent headaches that tend to get worse;
• symptoms of traumatic brain injury: nausea, dizziness, loss of consciousness, tinnitus, difficulty in perceiving information and orientation in space, loss of coordination;
• decreased memory, intelligence, loss or deterioration of vision and hearing;
• severe pain in the joints, radiating to different parts of the body.

As with most disorders in the human body, in this case the rule “the earlier the patient asked for help, the higher the chances of a successful outcome” is also relevant. Therefore, having discovered similar symptoms in yourself, you should not postpone going to the doctor. Perhaps, first you need to consult a therapist, and for children – a pediatrician, and then the doctor will refer you to the appropriate specialist. You can get an appointment with a neurosurgeon in a polyclinic, hospital, specialized medical institution – private or public.

Treatment methods used by a neurosurgeon

First of all, a neurosurgeon should use all the methods available to him to diagnose and study the disease with which the patient applied. To do this, the specialist interviews the patient, examines the information received about the symptoms, possible injuries, injuries previously received by the patient, about the diseases that were previously transferred to him, and also conducts an examination.

Usually, to establish a complete and distinct clinical picture of the problem, only an external study and questioning is not enough, so the neurosurgeon prescribes special tests and studies. It could be:

• radiography;
• computed or magnetic resonance imaging;
• ultrasound examinations, including dopplerography;
• myelography;
• puncture of an abscess or tumor;
• biopsy of a vertebra or tumor;
• general and detailed blood test;
• blood clotting testing;
• electroencephalography;
• echoencephalography.

The listed examinations are especially relevant before deciding on the need for surgical intervention. Emergency operations can be carried out without carrying out the listed studies, if we are talking about the need to take urgent measures to save a person’s life.

If the results of the examination indicate that the treatment can be carried out without a surgical operation, the neurosurgeon refers the patient to the appropriate specialist. If surgery is necessary, the doctor may prescribe drug therapy as a preparation for the surgical procedure.

The surgical method of treatment is the main one in the work of a neurosurgeon. Often, operations are performed under local anesthesia. On average, they can last from 3 to 5 hours, although, of course, there are cases when the operation lasts more than 10-12 hours. Then a colleague of the same specialization can come to the aid of a neurosurgeon. It is because of this duration that general anesthesia is practically not used for patients with diseases of the nervous system – it can pose a threat to their lives.

The surgical procedure requires maximum concentration, attentiveness and speed in making life-saving decisions from the doctor in case something goes wrong.

In the case when it is still necessary to introduce the patient into a state of medical sleep (the so-called general anesthesia), an injection or inhalation method is used using special anesthesia machines.

The operation itself takes place in several stages – first, the doctor makes an incision in the skin in the place where the intervention will be performed. After that, the neurosurgeon performs actions aimed at gaining access directly to the place of operation, for example, trepanning the cranium. At the end of the operation, the neurosurgeon restores the integrity of the site of the operation and sews up the incision on the skin.

The postoperative period always passes with rehabilitation measures prescribed by a neurosurgeon – this can be massage, drug therapy, bed rest for the first time after surgery and a sparing regime of work and rest in the future, special exercise therapy, dietary restrictions.

Recommendations from a neurosurgeon: how to save your health

Most injuries and diseases of the spine, brain and spinal cord, nervous system occur through the fault of the person himself. Of course, we are not talking about congenital pathologies, injuries after attacks, disasters or accidents. However, for example, an unreasonable approach to sports can often cause a patient to end up on the operating table.

Therefore, experts advise to treat training and physical activity very carefully, do not skip the warm-up and warm-up before physical exercises, perform the exercises themselves, strictly adhering to the technique or under the supervision of a trainer, and also do not forget about short breaks between sets so as not to exhaust the body. Feeling unwell during a workout, it must be stopped immediately, and then seek medical help.

A neurosurgeon is a specialist in the diagnosis and treatment of diseases and pathologies of the spinal cord, brain, and nervous system. His area of ​​responsibility is more related to the conduct of surgical intervention, although in certain cases he also prescribes medication.

To qualify as a neurosurgeon, future specialists are trained first at medical universities, and then at the residency stage, where they first encounter consultative practice. A certificate for work as a neurosurgeon is received only by those doctors who have worked for the required number of years in residency in their field.

In addition to theoretical and practical knowledge of medicine, a neurosurgeon must understand anatomy, radiology, mathematics, biology, and chemistry. In order to practice in this narrow and specific industry, such personal qualities as stress resistance, tolerance, accuracy, mental stability and a desire to help people are needed.