A doctor who specializes in brain surgery belongs to the field of neurosurgery. Neurosurgical interventions are necessary for diseases of the nervous system when conservative treatments or radiotherapy are not an option. Even if these forms of therapy have not been successful.
The nervous system is made up of a central and a peripheral part.
The central nervous system or CNS includes
- The brain and
- The spinal cord
The peripheral nervous system begins with the nerve tracts that originate from the spinal cord. These nerve branches branch out further until all parts of the body are supplied. Brain surgery exclusively involves the surgical treatment of diseases of the brain.
Neurosurgery deals with diseases of the central and peripheral nervous system that require surgery @ romaset /AdobeStock
Like most other parts of the body, the brain is made up of a variety of tissues. Therefore, the possible brain diseases are diverse and arise from different causes.
Neoplasia of the brain tissue, nerve damage, muscle or metabolic diseases as well as bone fractures or vascular disorders require brain surgery.
Common diseases that lead to brain surgery are
To perform brain surgery, the neurosurgeon opens the patient's skull (craniotomy). The access does not always have to be large.
Sometimes a tiny opening in the sinus area through which the doctor inserts the instruments (endoscope) is sufficient. Open brain surgery is also possible.
This is necessary, for example, to completely remove a large tumor . In the case of brain swelling following trauma, the doctor also removes part of the skull (craniectomy). This allows him to minimize the pressure of the inflammation.
The treatment method used in brain surgery depends on the type of disease. Whether tumor, cerebrospinal fluid outflow disorder or epilepsy - there are specific procedures for each disease.
In epilepsy surgery and tumor treatment, the brain surgeon must remove parts of the brain tissue.
In the case of a cerebrospinal fluid outflow disorder, a puncture of the ventricle is sufficient. This allows the fluid to drain away.
Aneurysms can be closed by the surgeon inserting a small coil into the affected vessel.
The treatment methods used in brain surgery are varied.
Other specific methods include
- Placement of shunts (e.g. cerebral shunt for hydrocephalus)
- Exposure or severing of nerves
- Cutting of brain areas or connections (e.g. for severe psychiatric disorders)
- Brain stimulation with electrical impulses
- Catheter implantations
The latest medical techniques are used in neurosurgery. Every surgical procedure is associated with tissue trauma.
However,microsurgical procedures and intensive monitoring ensure that the smallest vessels and sensitive brain structures are spared.
Most treatments are computer-assisted. The brain surgeon operates with an exact 3D representation. Even computer-controlled instrument guidance is now possible for some procedures.
Deep brain stimulation is a form of treatment for Parkinson's disease, for example, in which doctors surgically insert fine electrodes into the patient's brain @ Silver Place /AdobeStock
In order to diagnose a disease that requires neurosurgical treatment, the doctor uses various procedures.
These include
- The medical history
- The detailed patient interview and
- The physical examination
After evaluating the patient's general health and bodily functions, the doctor extends the examination with neurological tests. These can be used to detect nerve damage or nerve dysfunction.
For brain surgery, the patient must be fit for anesthesia. General anesthesia is necessary for most neurosurgical procedures.
To ensure that the anesthesia is tailored to the patient, the doctor checks the patient 's blood pressure and blood values. The measurement of organ values such as kidney and liver values helps the anaesthetist to plan a circulation-stabilizing infusion management.
Before the operation, the brain surgeon needs to know exactly how advanced the disease is. In the case of a malignant tumor, for example, it is crucial to know which parts of the brain are affected.
The doctor uses imaging techniques to determine the progress of the disease and to plan the operation.
This usually involves
The brain is imaged at all levels. Even the smallest changes are visible and can be precisely measured.
Other diagnostic procedures for brain diseases may include
The type of disease and the extent of the changes show the brain surgeon how large the surgical field needs to be. This determines which procedure (minimally invasive or open surgery) is used.
For patients, every brain operation is associated with a certain rehabilitation period. After the operation, patients can expect to stay in hospital for at least ten to twenty days. If a minimally invasive procedure is used, the recovery time is usually shorter.
Computed tomography (CT) is an X-ray examination that provides detailed cross-sectional images of the brain @ Yakobchuk Olena /AdobeStock
Brain surgery as a branch of neurosurgery deals with the surgical treatment of a wide range of diseases. Specialists in brain surgery can be found in specialized clinics. Doctors often focus on a specific area within head and brain surgery.
For example, you can look for doctors who specialize in minimally invasive techniques. Others may specialize in neurotraumatology or pediatric surgery, for example.
Brain specialists receive their full license to practice medicine with their license to practice medicine. Entry as a junior doctor enables further training to become a specialist in neurology. Only those doctors who have completed several years of specialist training may call themselves "specialists in neurology".
Specialist training takes five to six years. During their training, doctors must work in inpatient neurological patient care for at least 24 months.
They must also work in the following facilities for twelve months:
- Child and adolescent psychiatry and psychotherapy
- Psychiatry and psychotherapy and/or
- Psychosomatic medicine and psychotherapy
During their specialist training, they must also work for six months in the intensive medical care of neurological patients.
