Objectives of Neurosurgery

A neurosurgeon is a physician who specializes in treatment and surgery of the nervous system and its surrounding structures. Neurosurgeons operate on the brain, skull, scalp and spinal column.

Because of advances in technology, (the MRI and CAT Scan, the ICP monitor and the shunt), brain injury, in general, is more likely to have a positive outcome than it did several years ago.

One of the most important roles the neurosurgeon performs in the treatment of brain injury is in the prevention of further damage to the brain. This is accomplished in several ways.

When the brain is injured, the brain will swell. Because it is encased within the skull, this swelling will cause parts of the brain to compress. This compression decreases the blood flow and oxygen to parts of the brain which, in turn, causes more swelling.

One of the goals of the neurosurgeon is to break or diminish this cycle. This can be accomplished by removing any hematomas (blood clots) which are pressing on the brain and surgically repairing damaged blood vessels to stop any further bleeding. This gives the brain more room, increased blood flow and helps stem the cycle of compression and swelling. In severe cases, portions of the brain that are damaged beyond recovery may be removed to increase chances of recovery for the healthy portions of the brain.

The neurosurgeon is also responsible for the insertion of Intracranial Pressure monitoring devices. These devices, which measure the pressure within the brain, alert the medical team to increases in pressure, allowing them to intervene when dangerous levels are reached. A shunt or ventricular drain may be used to drain off excess fluids or surgical intervention may be called for.

The overall goal of the neurosurgeon is to maintain blood flow and oxygen to all parts of the brain, thus minimizing the damage and increasing the prospect of survival and recovery.