What does a neurosurgeon do?
Neurosurgeons specialize in the surgical treatment of diseases that affect the nervous system. This is an extremely broad definition because neurosurgeons have a very broad set of skills. They perform surgery on the skull, brain, spine, spinal cord, the blood vessels within the brain, and many of the large nerves that exit the spinal cord and skull.
When should I see a neurosurgeon?
Generally, seeing a neurosurgeon is a step that comes after several failed medical treatments, therapy appointments, and potentially even visits to other medical specialists. While this may seem frustrating, neurosurgery can be risky, has long recovery times, and has the potential to lead to death or disability. For this reason, neurosurgeons need to know that their treatments are truly required and that all other options are exhausted.
Some signs that a neurosurgeon is likely to be involved in your care are:
- Sudden loss of control over your bowels or bladder that continues after the initial event.
- Signs of stroke (sudden weakness, facial droop, arm droop, and speech changes)
- Severe trauma to the head leading to loss of consciousness
- Gradually increasing weakness of your upper or lower extremities
- Cancer that has started in the brain or spread to the brain
- Cancer that is affecting the spinal cord
What happens at a neurosurgeon appointment?
A visit with a neurosurgeon is typically laser-focused on whether or not you will benefit from surgery and how quickly that surgery should be done. Many of their evaluations are similar to those of other doctors. They will take a brief history and perform a physical examination. This examination will be focused on the neurological system and involve tests of strength, coordination, sensation, and balance.
Neurosurgeons do not typically perform procedures in the office setting. Their surgeries require large amounts of set-up time, sterile environments, and complex tools. They will likely order scans of the brain or spine to help with surgical planning and determine when or if surgery is required.
What are the most common reasons for neurosurgery?
There are four main situations that lead to the majority of neurosurgery appointments: having a device implanted in the brain, removing a tumor from the brain, treating trauma to the brain, and for the evaluation of severe chronic back pain that may require spinal surgery.
Devices in the brain
There are several devices that can be implanted in or near the brain which help to manage chronic diseases. An excess of fluid in the brain (hydrocephalus) is treated with the placement of drains. People with severe neurological diseases such as Parkinson’s can benefit from deep brain stimulators, which are electrical devices that help to “drown out” abnormal signals in the brain.
Tumors in the brain
Neurosurgeons are best known for the removal of tumors in and around the brain. The most common of these tumors are benign, meaning that they do not spread. However, these tumors can compress the brain and cause issues unless they are removed. Neurosurgeons can also remove certain forms of brain cancer (tumors that spread). This may not cure the cancer but can add many years to a patient’s life.
Trauma to the brain
Severe trauma to the head can cause the brain to swell. This swelling can damage the brain by pushing it against the skull, putting pressure on the delicate brain tissue. A neurosurgeon can cut away parts of the skull temporarily to allow this swelling to occur without further damaging the brain. They may also drill small holes in the skull to drain blood collections that are leading to compression of the brain after trauma.
Severe chronic back pain
Severe and disabling back pain can sometimes be caused by damage to the bones or cartilage of the spine. This can compress the spinal cord or the nerves leaving it which leads to severe pain. If medical treatments, physical therapy, and changes to your lifestyle do not resolve your symptoms, you may need to see a neurosurgeon.
Do neurosurgeons only do surgery?
No, neurosurgeons also see patients in clinics. However, these clinic appointments are typically based around preparing patients for surgery or following up with them after surgery. Much of a neurosurgeon's time is focused on major surgeries in the hospital setting. Neurosurgeons may also evaluate patients in the emergency department that are unlikely to require surgery but need close monitoring due to severe head trauma that has led to skull fractures or a small amount of bleeding near the brain.
