Neurosurgery
21848
226059404
2008-07-16T17:22:55Z
Dwayne Reed
7262504
/* History */ fixed caption
{{Articleissues|rewrite=February 2008|unreferenced=February 2008}}
[[Image:Parkinson surgery.jpg|thumb|right|Insertion of an electrode during neurosurgery for [[Parkinson's disease]].]]
'''Neurosurgery''' is the [[surgery|surgical]] discipline focused on treating those [[central nervous system|central]], [[peripheral nervous system]] and spinal column diseases amenable to mechanical intervention. "Brain surgery" is commonly used, much like [[rocket science]], to refer to a task requiring significant knowledge and skill.
==History==
[[Image:Structural.gif|thumb|right|Para-sagittal MRI of the head in a patient with benign familial macrocephaly. [[MRI]] are frequently performed prior to neurosurgery.]]
Unearthed remains of successful brain operations, as well as surgical implements, were found in France at one of Europe's noted archaeological digs. The success rate was remarkable, even circa 15,000 B.C.{{Fact|date=June 2008}}
Pre-historic evidence of brain surgery was not limited to Europe. Pre-Incan civilization used brain surgery as an extensive practice as early as 2,000 B.C. In Paracas, Peru, a desert strip south of Lima, archeologic evidence indicates that brain surgery was used extensively. Here, too, an inordinate success rate was noted as patients were restored to health. The treatment was used for mental illnesses, epilepsy, headaches, organic diseases, [[osteomylitis]], as well as head injuries.
Brain surgery was also used for both spiritual and magical reasons; often, the practice was limited to kings, priests and the nobility.
Surgical tools in South America were made of both bronze and man-shaped [[obsidian]] (a hard, sharp-edged volcanic rock).
Africa showed evidence of brain surgery as early as 3,000 B.C. in [[papyrus]] writings found in Egypt. "Brain," the actual word itself, is used here for the first time in any language. Egyptian knowledge of anatomy may have been rudimentary, but the ancient civilization did contribute important notations on the nervous system.
[[Hippocrates]], the father of modern medical ethics, left many texts on brain surgery. Born on the Aegean Island of Cos in 470 B.C., Hippocrates was quite familiar with the clinical signs of head injuries. He also described seizures accurately, as well as spasms and classified head contusions, fractures and depressions. Many concepts found in his texts were still in good stead two thousand years after his death in 360 B.C.
Ancient Rome in the first century A.D. had its brain surgeon star, Aulus Cornelius Celsus. Hippocrates did not operate on depressed skull fractures; Celsus often did. Celsus also described the symptoms of brain injury in great detail.
Asia was home to many talented brain surgeons: Galenus of Pergamon, born in Turkey, and the physicians of Byzance such as Oribasius (4th century) and Paul of Aegina. An Islamic school of brain surgery also flourished from 800 to 1200 A.D., the height of Islamic influence in the world. Abu Bekr Muhammed el Razi, who lived from 852 to 932 in the Common Era, was perhaps the greatest of Islamic brain surgeons. A second Islamic brain surgeon, Abu l'Qluasim Khalaf, lived and practiced in Cordoba, Spain, and was one of the great influences on western brain surgery.
The Christian surgeons of the old Ages were clerics, well educated, knowledgeable in Latin, and familiar with the realm of medical literature. Despite the church's ban on study of anatomy, many churchmen of great renown (advisors and confessors to a succession of Popes) were outstanding physicians and surgeons. [[Leonardo da Vinci]]'s portfolio containing hundreds of accurate anatomical sketches indicates the intense intellectual interest in the workings of the human body despite the Church's own brain surgery.
==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 even death.
==Conditions==
Neurosurgical conditions include primarily [[human brain|brain]], [[spinal cord]], vertebral column and [[peripheral nervous system|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]] [[Physical trauma|trauma]]
*[[Physical trauma|Traumatic injuries]] of [[peripheral nervous system|peripheral nerves]]
*[[Brain tumor]]s
*[[Infections and infestations]]
*[[Tumour]]s of the [[vertebral column|spine]], [[spinal cord]] and [[peripheral nervous system|peripheral nerves]]
*[[Cerebral aneurysm]]s
*[[Stroke]], including [[stroke|hemorrhagic stroke]] and [[stroke|ischemic stroke]]
*Intracerebral hemorrhage, such as [[subarachnoid hemorrhage]], intraparenchymal, and intraventricular [[hemorrhage]]s
*Some forms of pharmacologically resistant [[epilepsy]]
*Some forms of [[movement disorder]]s (advanced [[Parkinson's disease]], [[chorea]]){{ndash}} this involves the use of specially developed minimally invasive [[stereotaxy|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
*[[Malformation]]s of the [[nervous system]]
*[[Carotid artery stenosis]]
*Vascular malformations (i.e., [[arteriovenous malformation]]s, venous angiomas, [[cavernous angioma]]s, 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]]
==Job field==
In the United States neurosurgical training is very competitive and grueling. It usually requires six to eight years of residency after completing medical school, plus the option of a fellowship for subspecialization (lasting an additional one to three years). Most applicants to neurosurgery training programs have excellent medical school grades and evaluations, have published scientific and/or clinical research, and have obtained board scores in the 95th percentile or higher. Resident work hour limits are set at 88 hours per week for many programs, although many neurosurgical programs have had problems meeting these new work hour limits due to the small size of residency programs, the high volume of neurosurgical patients, and the need to provide constant coverage in the emergency room (ER), operating room (OR), and intensive care unit (ICU).
All neurosurgical residency programs have some form of research included in the training. Most programs include one year of research time, which can be clinical, translational, or basic science research. Some programs offer two or more years of research, and may offer the ability to complete a second degree, such as a PhD, MPH, Masters of Science, etc.
On average 50-60% of medical students applying to neurosurgery match into a residency program (about 80% of US senior medical student applicants).<ref name="2008MatchList">{{cite web |url=http://uncleharvey.com/index.php/wiki/2008_Match_List_for_Neurological_Surgery |title=2008 Match List for Neurological Surgery | UncleHarvey.com Wiki |accessdate=2008-03-15 |format= |work=}}</ref>
==Career==
The average compensation for a neurosurgeon ranges from US $250,000-$500,000 annually. MGMA data from 2001 for US neurosurgeons show an average of $410k in private practice, $275k in academics, and $438k for all neurosurgeons at least three years out of training.
==See also==
* [[Anton Eiselsberg]]{{ndash}} Established Neurosurgery as an independent discipline
* [[Bio-plate]]
* [[Gazi Yasargil]]{{ndash}} Known as the father of modern neurosurgery
* [[Harvey Cushing]]{{ndash}} Known as the father of neurosurgery
* [[Ben Carson]]{{ndash}}Famous African American Neurosurgeon
* [[Brian Andrews (doctor)]] {{ndash}} Noted American Neurosurgeon
==References==
{{reflist}}
==External links==
{{external-links}}
*[http://www.cns.org/ Congress of Neurological Surgeons]
*[http://www.aans.org/ American Association of Neurological Surgeons]
*[http://www.abns.org/ American Board of Neurological Surgery]
*[http://www.nsa.org.au/ Neurosurgical Society of Australasia]
*[http://www.brain-surgery.us/ Brain Surgery-Neurosurgery Patient Help Site]
*[http://www.eans.org European Association of Neurosurgical Societies]
*[http://www.sinstruments.com/neurosurgery.html Surgical Instruments used in Neurosurgery]
{{Medicine}}
{{Neurosurgical procedures}}
{{Neuroscience}}
[[Category:Neurosurgery|*]]
[[Category:Surgical specialties]]
[[ca:Neurocirurgia]]
[[da:Neurokirurgi]]
[[de:Neurochirurgie]]
[[es:Neurocirugía]]
[[eu:Neurokirurgia]]
[[fr:Neurochirurgie]]
[[ko:신경외과]]
[[it:Neurochirurgia]]
[[he:נוירוכירורגיה]]
[[mk:Неврохирургија]]
[[nl:Neurochirurgie]]
[[ne:स्नायुशल्यचिकित्सा]]
[[ja:脳神経外科学]]
[[no:Nevrokirurgi]]
[[pl:Neurochirurgia]]
[[pt:Neurocirurgia]]
[[ru:Нейрохирургия]]
[[simple:Neurosurgery]]
[[sl:Nevrokirurgija]]
[[fi:Neurokirurgia]]
[[sv:Neurokirurgi]]
[[tr:Beyin ve sinir cerrahisi]]
[[zh:神經外科]]