Neurosurgery: Operations Performed by a Neurosurgeon

Neurosurgery is a term that refers to any surgical procedure or operation having to do with the neurovascular system, and it is performed by a neurosurgeon.

Definition: What is a neurosurgeon?

A neurosurgeon (commonly referred to as a brain surgeon) is a highly trained and specialized medical professional and surgeon who treats the neurovascular system of the body. Neurovascular includes anything and everything to do with the brain, spinal cord, nerves, and vessels (blood and lymphatic).

Career of a Neurosurgeon

How long does it take to become a neurosurgeon?

Neurosurgery is a highly specialized field requiring six to eight years of residency training in neurosurgery. This is after completing the required education to become a medical doctor (M.D. or D.O.). Essentially these are the three steps in becoming a neurosurgeon.

  1. Bachelor’s Degree, pre-med (4 years)
  2. Medical School (4 years)
  3. Residency Program for Neurosurgery (6-8 years)

What is the annual salary of a neurosurgeon?

This can range depending on location, training, experience and any other specialties. Generally, a neurosurgeon can make anywhere from $350,000 to $1,200,000 as an annual salary.

What type of procedures, operations or surgeries do neurosurgeons do?

Below is a list of some surgeries performed by neurosurgeons and a brief explanation of the procedure.

Aneurysm Repair

An aneurysm is when the walls of an artery (blood vessel) weaken; they then become too relaxed to maintain good pressure against the flow of blood and begin to bulge or swell (sometimes called ballooning) with blood flow to the weakened area. If the bulge becomes too large it can rupture. This is an emergent situation and needs immediate medical attention. A neurosurgeon can repair aneurysms (before and sometimes after they rupture) by a variety of different techniques.

Carotid Artery Endarterectomy

The carotid artery is the main blood vessel that provides blood flow to the brain. When plaque (formed by fatty deposits) builds up in the carotid artery (otherwise known as carotid artery disease or CAD) this can cause a blockage of blood flow to the brain. A Carotid Artery Endarterectomy is a procedure used to treat this disease and involves removing the built up plaque.

Craniotomy

brain-mriIf the brain needs accessed for surgery, a craniectomy or craniotomy maybe performed. In this procedure the brain is accessed by removing a portion of the skull bone. The brain may need to be accessed directly in cases such as tumor removal or treatment, foreign object removal, to relieve pressure from swelling or bleeding (or hematomas) in the brain, to treat brain aneurysms, to treat skull fracture, or to treat infection.

Disk Removal, Ruptured

Little shock absorbing discs are positioned throughout the spine to allow for the movement and pressures that result from normal daily activities. As we age or perhaps overwork parts of our spine (most commonly affected is the lumbar and cervical regions) these discs, made of connective tissue, can become weakened, damaged, bulged, torn or misplaced. When they are, this can result in pain and other symptoms. Sometimes it can be treated with medications, physical therapy or other non-surgical procedures and other times a surgery may be needed.

Endovascular Surgery

Endovascular surgery, performed by a neurosurgeon, is a procedure used to treat an array of varying vascular (blood vessel and/or lymphatic system) related conditions. Typically in this procedure, an incision is made near the hip to access the affected vessel.

Laminectomy

Shrinking of discs in the spine and swelling or inflammation of ligaments or bones can cause pressure on the spinal cord and/or nerves, resulting in severe chronic or acute pain. This pressure can be relieved by removing part of the lamina (a part of the spinal vertebrae). This is done in a procedure, performed by a neurosurgeon, called a laminectomy.

Spinal Tap (lumbar puncture)

A lumbar puncture, more commonly known as a spinal tap, is a procedure done to sample fluid found in the spinal column for diagnostic purposes. The fluid extracted is called Cerebral Spinal Fluid (CSF) and is removed with a needle that is inserted between two lumbar (lower back) vertebrae and into the subarachnoid space (a specific area of the spinal cord). A lumbar puncture may also be done to treat conditions such as hydrocephalus; to administer pain or numbing medication; to administer contrast dye; or to measure and/or control CSF pressure.

Sympathectomy

The nervous system of the human body can be divided into two categories: sympathetic nervous system and parasympathetic nervous system. While very complex, the basic difference between the two systems is what they are responsible for: the sympathetic nervous system (SNS) is responsible for action–also known as the “fight or flight response,” while the parasympathetic nervous system (PNS) is responsible for calming actions–also known as the “rest and digest” system.

In conditions where a sympathetic nerve is overactive or causes an excessive response a sympathectomy can be done. Simply put, a neurosurgeon can cut and remove or block a sympathetic nerve (otherwise known as a ganglion) so that it no longer functions, or is temporarily blocked. This is often done in conditions like hyperhidrosis (an excessive sweating condition)–so the nerve that triggers the sweat gland to produce in a fight or flight response is cut, thus reducing the trigger to the sweat gland, helping to treat this condition.

Resources

Congress of Neurological Surgeons