Neurosurgery

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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

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]

One of the earliest forms of brain surgery is trepanning (or trephining), it involved creating a hole in a person's skull to release what they probably thought were evil spirits.

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] Neurosurgeons can also pursue fellowship training in neuropathology and neuro-ophthalmology.

In the UK students must earn A*- C Grades at GCSE (General Certificate of Secondary Education), then they must also achieve A*- C at A levels in Chemistry with at least one other Science or Maths. Also a UKCAT (UK Clinical Aptitude Test) or BMAT (BioMedical Admissions Test) can be used to gain access into some Medical Schools. Students have to study medicine for 5 years and achieve an MBBS qualification (Bachelor of Medicine and Bachelor of Surgery). Then the student must perform Foundation training lasting normally 2 years, this is a paid training job in a hospital or clinical situation setting covers a range of Medical specialties including Surgery. Core Surgical training is then taken which lasts for 2 years the difference in this is that the training would be themed towards a particular speciality.[6]

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.

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