neurosurgery

Neurosurgery

Neurosurgery is a surgical specialty focused on the diagnosis, treatment, and management of disorders affecting the nervous system, including the brain, spinal cord, and peripheral nerves.

It is a highly specialized field within medicine, and these procedures are typically performed by neurosurgeons who have extensive training and expertise in the diagnosis and treatment of neurological disorders.

see Neurosurgeons.

Neurosurgical Training.

Technology and Innovation: Neurosurgery has seen significant advancements in recent years, thanks to the development of minimally invasive techniques, computer-assisted navigation, and neuroimaging technologies like MRI and CT scans. These innovations have improved the precision and safety of neurosurgical procedures.

Collaboration.

Subspecialties: Within neurosurgery, some subspecialties focus on specific areas, such as pediatric neurosurgery, functional neurosurgery (treating conditions like Parkinson's disease), and neuro-oncology (treating brain and spinal cord tumors).



Neurosurgery (or neurological surgery), constitutes a medical discipline and surgical specialty that provides care for adult and pediatric patients in the treatment of pain or pathological processes that may modify the function or activity of the central nervous system (e.g. brain, hypophysis, and spinal cord), the peripheral nervous system (e.g. cranial, spinal, and peripheral nerves), the autonomic nervous system, the supporting structures of these systems (e.g. meninges, skull & skull base, and vertebral column), and their vascular supply (e.g. intracranial, extracranial, and spinal vasculature).

Treatment encompasses both non-operative management (e.g. prevention, diagnosis – including image interpretation – and treatments such as but not limited to neurocritical intensive care and rehabilitation) and operative management with its associated image use and interpretation (e.g. endovascular surgery, functional and restorative surgery, stereotactic radiosurgery, and spinal fusion – including its instrumentation.


They require precise and dexterous manipulation of a surgical suture in narrow and deep spaces in the brain. This is necessary for surgical tasks such as the anastomosis of microscopic blood vessels and dura mater suturing.

Neurosurgical procedures lead to great psychological stress. In the past decade, several strategies and techniques have been implemented to minimize the patient's emotional stress 1) 2).

The esthetic aspect, not considered so important in the past, is now an important feature in the recovery and the quality of life in the postoperative period 3)


Today, neurosurgery is part of the portfolio of all university hospitals. It is a highly specialized service that, because of high costs, is often centralized.

Neurosurgery is one of the fastest-developing medical specialties, and results are continuously improving through the introduction of new treatment methods. Recent major advancements in neurosurgery include the application of microsurgery, the advancements in Imaging techniques, and the high quality and increased amount of a intensive care unit.

To improve the cost transparency of the local health care system, treatment cost was recently referenced to disease related groups (DRG). To define a valid case mix index (CMI), patient status at admission must be well documented. Concurrently, treatment quality must be closely monitored to provide transparency between health care providers concerning the clinical outcome and the complications during the treatment process 4) 5) 6).

see Books.

Neurosurgery Journal

see Neurosurgery Journal

Impact factor: 4.605 (2018)

Globally, the lack of access to basic surgical care causes 3 times as many deaths as HIV/AIDS, tuberculosis, and malaria combined. The magnitude of this unmet need has been described recently, and the numbers are startling. Major shifts in the global health agenda have highlighted access to essential and emergency surgery as a high priority. A broad examination of the current global neurosurgical efforts to improve access has revealed some strengths, particularly in the realm of training; however, the demand grossly outstrips the supply; Most people in low-income countries do not have access to basic surgical care, either due to lack of availability or affordability. Projects that help create a robust and resilient health system within low- and middle-income countries require urgent implementation. In this context, concurrent scale-up of human resources, investments in capacity building, local data collection, and analysis for accurate assessment are essential. In addition, through the process of collaboration and consensus building within the neurosurgical community, a unified voice of neurosurgery is necessary to effectively advocate for all those who need neurosurgical care wherever, whenever 7).


1)
Angelini GD, Butchart EG, Armistead SH, Breckenridge IM. Comparative study of leg wound skin closure in coronary artery bypass graft operations. Thorax. 1984;39:942–5.
2)
Bekar A, Korfali E, Dogan S, Yilmazlar S, Baskan Z, Aksoy K. The effect of hair on infection after cranial surgery. Acta Neurochir (Wien) 2001;143:533–6. discussion 537.
3)
Cho J, Harrop J, Veznaedaroglu E, Andrews DW. Concomitant use of computer image guidance, linear or sigmoid incisions after minimal shave, and liquid wound dressing with 2-octyl cyanoacrylate for tumor craniotomy or craniectomy: Analysis of 225 consecutive surgical cases with antecedent historical control at one institution. Neurosurgery. 2003;52:832–40. discussion 840-1.
4)
Clark JC, Spetzler RF. Creating a Brave New World for Neurosurgery. World Neurosurgery. 2011; 75 (5):608–9. doi: 10.1016/j.wneu.2010.12.032
5)
Scho¨b O, Kocher T, Langer I. Fu¨nf Fragen an die Medizinische Qualita¨tssicherung: Die Selbststeuerung erhalten. Bulletin des me´decins suisses. 2014; 95(39):1446–8.
6)
OECD/WHO. OECD Reviews of Health Systems: Switzerland 2011.
7)
Park KB, Johnson WD, Dempsey RJ. Global Neurosurgery: The Unmet Need. World Neurosurg. 2016 Apr;88:32-5. doi: 10.1016/j.wneu.2015.12.048. Epub 2015 Dec 28. PubMed PMID: 26732963.
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