1. Neurologic surgery specializes in primarily surgical management
of central, peripheral, and autonomic nervous system disorders.
2. Although clinical examination is paramount, neurosurgical diagnosis
and treatment are aided largely by a variety of modalities, such
as magnetic resonance imaging and intracranial pressure monitoring.
3. The common treatment goals for traumatic brain and spinal injury
are aimed at preventing secondary insults of hypoxia and hypotension.
4. Aneurysmal subarachnoid hemorrhage remains one of the most morbid
and intensive neurosurgical diseases. Endovascular therapy is a
growing technology that allows for safer securing of ruptured aneurysms.
5. Brain tumors can arise from primary or metastatic tissues. Treatment
typically involves resection, followed by radiation and/or
chemotherapy, depending on the type and grade of tumor.
6. Degenerative spine disease affects mainly the cervical and lumbar
regions. Narrowing of the canal in the cervical spine may cause
myelopathy or radiculopathy, while narrowing in the lumbar spine
results in radiculopathy, neurogenic claudication, or cauda equina
7. Spinal instrumentation is used for surgical stabilization of
many types of spinal instability, including traumatic, infectious,
oncologic, and degenerative.
8. Infection of the nervous system is a serious and prevalent medical
problem. Operative management is indicated for most conditions in
which there is symptomatic compression of neural structures.
9. Functional neurosurgery via device implantation is a rapidly
evolving discipline that has already become the standard of care
in treating medically refractory Parkinson’s disease and
essential tremor. A wider variety of deep brain stimulation targets
will treat additional neuropsychiatric diseases.
10. Stereotactic radiosurgery is a powerful treatment option for
intracranial disease, whether it is primary or adjunct. Gamma knife
surgery can be used to treat tumors, vascular malformations, and
Neurologic surgery is a discipline of medicine and the specialty
of surgery that provides the operative and nonoperative management (i.e.,
prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation)
of disorders of the central, peripheral, and autonomic nervous systems
(ANSs). This includes their supporting structures and vascular supply;
the evaluation and treatment of pathologic processes that modify
the function or activity of the nervous system, including the hypophysis;
and the operative and nonoperative management of pain. Such disorders
include those of the brain, meninges, skull and skull base, and
their blood supply, including surgical and endovascular treatment
of disorders of the intracranial and extracranial vasculature supplying
the brain and spinal cord; disorders of the pituitary gland; disorders
of the spinal cord, meninges, and vertebral column, including those
that may require treatment by fusion, instrumentation, or endovascular
techniques; and disorders of the cranial and spinal nerves throughout their
An accurate history is the first step toward neurologic diagnosis.
A history of trauma or of neurologic symptoms is of obvious interest, but
general constitutional symptoms are also important. Neurologic disease
may have systemic effects, while diseases of ...