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Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.
Pediatrics is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the age of 18. The American Academy of Pediatrics recommends people seek pediatric care through the age of 21, but some pediatric subspecialists continue to care for adults up to 25. Worldwide age limits of pediatrics have been trending upward year after year. A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word pediatrics and its cognates mean "healer of children," derived from the two Greek words: παῖς and ἰατρός. Pediatricians work in clinics, research centers, universities, general hospitals and children's hospitals, including those who practice pediatric subspecialties.
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain. This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes.
Chiari malformation (CM) is a structural defect in the cerebellum, characterized by a downward displacement of one or both cerebellar tonsils through the foramen magnum. CMs can cause headaches, difficulty swallowing, vomiting, dizziness, neck pain, unsteady gait, poor hand coordination, numbness and tingling of the hands and feet, and speech problems. Less often, people may experience ringing or buzzing in the ears, weakness, slow heart rhythm, or fast heart rhythm, curvature of the spine (scoliosis) related to spinal cord impairment, abnormal breathing, such as central sleep apnea, characterized by periods of breathing cessation during sleep, and, in severe cases, paralysis.
Plagiocephaly, also known as flat head syndrome, is a condition characterized by an asymmetrical distortion of the skull. A mild and widespread form is characterized by a flat spot on the back or one side of the head caused by remaining in a supine position for prolonged periods.
Hemispherectomy is a neurosurgical procedure in which a cerebral hemisphere is removed or disconnected. It is used to treat a variety of refractory or drug-resistant seizure disorders (epilepsy). Refractory or drug-resistant epilepsy is defined as seizures that fail to be controlled using 2 or more appropriate anti-seizure medications. About one in three patients with epilepsy have drug-resistant epilepsy and of those, about half of them have focal epilepsy that can potentially be treated with epilepsy surgery. In drug-resistant epilepsy where all or most seizures arise from one hemisphere, hemispherectomy is a highly effective procedure producing seizure freedom in about 80-90% of patients. In addition to controlling seizures and as a result of that, improved development and cognition is also very frequently achieved after hemispherectomy. Most patients who qualify for hemispherectomy already have neurological deficits such as hemibody weakness or loss of vision in one visual field that is opposite to the side of the affected hemisphere. This means that performing hemispherectomy does not add deficits to a new hemisphere in these patients. However, detailed testing is always performed prior to epilepsy surgery in general to ensure that such procedures would achieve two goals: 1) eliminating or greatly reducing seizures and 2) causing no or minimal deficits that could impair the patient’s functionality.
Decompressive craniectomy is a neurosurgical procedure in which part of the skull is removed to allow a swelling or herniating brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke, Chiari malformation, and other conditions associated with raised intracranial pressure. Use of the surgery is controversial.
A cerebral shunt is a device permanently implanted inside the head and body to drain excess fluid away from the brain. They are commonly used to treat hydrocephalus, the swelling of the brain due to excess buildup of cerebrospinal fluid (CSF). If left unchecked, the excess CSF can lead to an increase in intracranial pressure (ICP), which can cause intracranial hematoma, cerebral edema, crushed brain tissue or herniation. The drainage provided by a shunt can alleviate or prevent these problems in patients with hydrocephalus or related diseases.
Endoscopic third ventriculostomy (ETV) is a surgical procedure for treatment of hydrocephalus in which an opening is created in the floor of the third ventricle using an endoscope placed within the ventricular system through a burr hole. This allows the cerebrospinal fluid to flow directly to the basal cisterns, bypassing the obstruction. Specifically, the opening is created in the translucent tuber cinereum on the third ventricular floor.
Roy Glenwood "Glen" Spurling was an American neurosurgeon remembered for describing Spurling's test.
Karin Marie Muraszko is Julian T. Hoff Professor and chair of the department of neurosurgery at the University of Michigan. She is the first woman to head a neurosurgery department at any medical school in the US. She specializes in brain and spinal cord abnormalities. She has a spinal cord abnormality, spina bifida.
Curtis Dickman is an American Neurosurgeon at Barrow Neurological Institute, and is recognized internationally for his pioneering work in the field of Thoracoscopic Neurosurgery. He serves as Director of the Spine Research Laboratory and Associate Chief of the Spine Section at Barrow Neurological Institute.
James Rutka is a Canadian neurosurgeon from Toronto, Canada. Rutka served as RS McLaughlin Professor and Chair of the Department of Surgery in the Faculty of Medicine at the University of Toronto from 2011 – 2022. He subspecializes in pediatric neurosurgery at The Hospital for Sick Children (SickKids), and is a Senior Scientist in the Research Institute at SickKids. His main clinical interests include the neurosurgical treatment of children with brain tumours and epilepsy. His research interests lie in the molecular biology of human brain tumours – specifically in the determination of the mechanisms by which brain tumours grow and invade. He is the Director of the Arthur and Sonia Labatt Brain Tumour Research Centre at SickKids, and Editor-in-Chief of the Journal of Neurosurgery.
Charles Anthony Fager was an American neurosurgeon, medical academic, and leader at the Lahey Hospital & Medical Center.
Eldon Leroy Foltz was born in Fort Collins, Colorado, Eldon L. Foltz grew up in East Lansing, Michigan. His father was Professor of Electrical Engineering at Michigan State University, and Foltz himself would go on to have a distinguished career as an academic and neurosurgeon.
Global neurosurgery is a field at the intersection of public health and clinical neurosurgery. It aims to expand provision of improved and equitable neurosurgical care globally.
Claire Karekezi is a Neurosurgeon at the Rwanda Military Hospital in Kigali, Rwanda. As the first woman neurosurgeon in Rwanda, and one of six neurosurgeons serving a population of 13 million, Karekezi serves as an advocate for women in neurosurgery. She has become an inspiration for young people pursuing neurosurgery, particularly young women.
Sandi Lam is a Canadian pediatric neurosurgeon and is known for her research in minimally invasive endoscopic hemispherectomy for patients with epilepsy. Lam is the Vice Chair for Pediatric Neurological Surgery at Northwestern University and the Division Chief of Pediatric Neurosurgery at Lurie Children's Hospital. She has spent her career advancing pediatric brain surgery capabilities globally through her work in Kenya performing surgeries as well as training and mentoring local residents and fellows.
Juliet Sekabunga Nalwanga is a physician from Uganda, who is the country's first female neurosurgeon. As of 2021 she was one of only thirteen neurosurgeons in Uganda. As of 2018 she was employed by Mulago National Referral Hospital in Kampala.
Fossa navicularis magna is a variant bony depression found at the midline of the occipital part of clivus. This fossa was first described by Tourtual. Its prevalence ranges from 0.9 to 5.3%.
References
- ↑ Youmans and Winn Neurological Surgery (7 ed.). Elsevier. 2017. pp. 1472–1475.
- ↑ "Neuroscience Center". Boston's Children Hospital. Retrieved 25 September 2020.
- ↑ Shipman, Scott A.; Lane, Jessica R.; Durham, Susan R. (1 January 2009). "The pediatric neurosurgical workforce: defining the current supply: Clinical article". Journal of Neurosurgery: Pediatrics. 3 (1): 1–10. doi:10.3171/2008.10.PEDS08255. ISSN 1933-0715. PMID 19119896 . Retrieved 2 April 2019.
- ↑ Maher, Cormac O.; Durham, Susan R.; Scott, R. Michael; Nadel, Jeffrey L. (4 January 2019). "Recent trends in North American pediatric neurosurgical fellowship training". Journal of Neurosurgery: Pediatrics. -1 (aop): 517–522. doi:10.3171/2018.10.PEDS18106. ISSN 1933-0715. PMID 30611157. S2CID 58625535 . Retrieved 2 April 2019.
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