Neurosurgery Explained

The Specialty of Neurosurgery

Surgeons operating on patient
Getty Images/Pete Saloutos

Neurosurgery is the surgical specialty that deals with the nervous system, including the brain, spinal cord and nerves of the body.

Types of Neurosurgeons

A neurosurgeon, who may also be referred to as a brain surgeon, is a specialist who has received extensive training in general surgery. The neurosurgeon typically trains as a general surgeon resident for five years, followed by many additional years receiving additional specialized training in neurosurgery for adults or children. These physicians are trained to diagnose, treat, rehabilitate and perform surgery to correct issues that may occur in the nervous system. 

If you need to have surgery on your brain or spinal cord, It is important to select a neurosurgeon who is very experienced in type of surgery that you need. It is also important to remember that there is some overlap with other surgical specialties, particularly orthopedics, as both specialties perform back surgeries and spinal surgeries.

Some neurosurgeons specialize in a specific area of the nervous system while others practice on the brain, neck, and spine. At smaller facilities, they often perform many types of neurosurgery, very specialized surgeons are more typically found at very large facilities. These surgeons may specialize in brain surgery, or they may be "super" specialized, for example, only performing surgeries to remove cancerous tumors from the brain. Others may specialize in surgery on the lower back, neck, or other areas. 

Pediatric Neurosurgery

Pediatric neurosurgery is the practice of neurosurgery on patients under the age of eighteen. Some adults may also be treated by a pediatric neurosurgeon, particularly if they have been treated by the neurosurgeon as a child or if the problem that requires surgical intervention was present at birth. These surgeons are very experienced at performing surgery that is necessary due to a birth defect or another problem that occurs early in life as they routinely correct these types of issues, regardless of the age of the patient. In some cases, the patient may be referred to neurosurgery at an early age but not need or be able to have corrective surgery until later in life. This is why it isn't totally unheard of to see an adult in the pediatric ICU or another pediatric surgical unit.

Reasons for Neurosurgery

In children, neurosurgery is typically needed to correct a problem that was present at birth, such as fluid collecting in the brain (hydrocephalus). Trauma is a very common reason for neurosurgery. After severe trauma to the head, the brain often begins to swell and surgery may be performed to release this pressure and to provide the brain with room to swell without causing further damage. 

Imagine spraining an ankle, afterward the ankle becomes bruised and swollen. The brain does the same thing when injured, but is surrounded by the bones of the skull. As the brain swells, pressure inside the skull increases and can cause additional damage. In some cases the swelling is so severe that a piece of the skull needs to be removed in order to allow the swelling to happen without damaging other areas of the brain. When the swelling goes down, the piece of skull can be replaced.

Cancer can also be the reason that neurosurgery is needed as cancer can occur in the brain and along the spinal cord. A tumor may need to be removed, or reduced in size during a procedure called debulking. 

The Future of Neurosurgery

Neurosurgery advances on a daily basis, with surgical techniques being discovered and perfected. Minimally invasive techniques are being developed to help minimize stress on the brain and body during surgery, and to enable the patient to recover more quickly and easily. You can expect to see more percutaneous procedures, which are procedures that don't require opening of the brain, and you can also expect to see less invasive versions of procedures that are currently being done.

A Word From Verywell

Neurosurgery is an important part of medicine, working to protect, heal and treat the brain. There are many reasons an individual may need a neurosurgeon, ranging from an issue present at birth to treating a spinal cord injury caused by trauma or even to decrease the damage caused by a stroke.

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