There are many different tools available to a neurosurgeon. An MRI is a
scanning device that uses a magnetic field, radio waves and a computer. MRI
stands for magnetic resonance imaging. Signals emitted by normal and diseased
tissue during the scan are assembled into an image that can show the surgeon
what the problem is and where it is located.
A CT or a CAT scan stands for computerized axial tomography. This refers
to an X-ray device linked to a computer that produces an image of a predetermined
cross-section of the brain. A special dye material may be injected into one
of the patient's veins prior to the scan to help make any abnormal tissue
more evident.
These two methods of collecting information from a person's nervous system
are fairly recent innovations. One type of test that is more invasive is a
biopsy. This is the extraction of a small amount of tissue from the patient's
body. The tissue is then examined to make a diagnosis.
Neurosurgeons may also perform a cerebral angiogram, which maps out a patient's
blood vessels in the brain.
Most of the technology used by neurosurgeons is quite advanced, and new
procedures are constantly being invented as new information is discovered.
"This type of surgery couldn't be done without the microscope," says Dr. Michael
Lusk. "Equally important have been the CAT scans and MRI scans."
Neurosurgery, surprisingly, is one of the oldest practiced medical arts.
There are records of neurosurgery in Babylon and Egypt as early as 3,000 years
before Christ.
Neurosurgeons perform their operations in hospital operating rooms, with
a host of people assisting them. Nurses, a resident, an anesthesiologist,
orderlies and sometimes technologists are present during an operation. To
a certain extent, neurosurgeons are involved in post-operative treatment,
although often other medical professionals, such as physical therapists, take
over where the surgeon left off.
Some of the illnesses that today's neurosurgeons treat are aneurysms (bulges
in blood vessels) in the brain, brain hemorrhages, brain and spinal cord injuries,
and all kinds of malignant and benign tumors.
Epilepsy and other neurological disorders like diabetic neuropathy are
also within the realm of the neurosurgeon. As well as operating on the brain,
neurosurgeons operate on the spinal cord. A head injury may affect more than
just the brain and the surgeon must have a good working knowledge of the whole
nervous system, as well as an understanding of how that system relates to
the entire body.
Pediatric neurosurgery is one area of specialization. It requires different
knowledge and techniques than surgery performed on an adult. Neurosurgeons
may also specialize in one or more disorders. This enables them to become
highly knowledgeable and skilled in one aspect of the field. They may even
be a driving force behind new studies and innovations in that area.
Neurosurgeons must prepare themselves for the chance that they will lose
a patient. "You shouldn't be in this career if you can't deal with that,"
warns neurosurgeon Dr. Robert Fink.
Because the brain is such an integral part of a human's personality and
being, neurosurgeons have one of the toughest and most stressful medical jobs
there is. Not only must they be highly trained in this area of medicine, they
must have top-notch skills and excellent manual dexterity. There's no room
for mistakes.
And because many of the procedures take hours to complete, a neurosurgeon
must have mental and physical stamina. The stress can be personal and intense.
"It's a very challenging field," says Dr. Andrea Halliday, a neurosurgeon.
Neurosurgeons usually work regular office hours in a hospital or private
clinic. "We work 9 to 4 and through lunch to accommodate some of our patients,"
says Fink. Some neurosurgeons are also affiliated with universities and may
teach or conduct research.
All surgery is performed at a hospital and the hours there can be more
hectic due to the lengthy nature of some operations. Spinal operations can
take up to three hours, but it's not uncommon for surgery to go on for 10
or more hours. "My personal record was an acoustic neuroma that took 14 hours,"
says Fink.
Most neurosurgeons also make themselves available to work in emergency
situations.
This is a career that is unable to accommodate most physical disabilities.
Surgeons often work in microscopic areas and the actions required can be miniscule.
Their hands are the basis for their entire careers.
That said, this doesn't preclude someone from becoming involved in other
areas of neurological medicine.