Types of Neurosurgeon Specialties

by Fred Decker

Neurosurgeons operate on the human brain and nervous system. They also work with systems and structures that support the nervous system, such as the spine and the circulatory system that supplies the brain with its blood. Neurosurgeons spend six years in residency, learning under the supervision of experienced colleagues. Many will go on to specialize in one of the field's many subdisciplines.

Cerebrovascular and Skull Base Surgery

Many common neurological conditions, such as aneurysms and stroke, are caused by problems within the brain's circulatory system. Cerebrovascular surgery is the sub-specialty that focuses on preventing and correcting these conditions. Some procedures are performed using traditional open surgical methods, while other procedures are performed with miniature instruments to repair veins from within. Skull base neurosurgeons work together with otolaryngologists, oncologists and plastic surgeons to remove once-inoperable tumors from the sinus cavities and other inaccessible areas. The neurosurgeon's expertise is largely cardiovascular, managing the surgery to avoid damaging the complex network of blood vessels in the area.

Neuro-Trauma and Neurological Critical Care

The skull and spine provide protection for nerves of the brain and spinal cord. However, accidents and acts of violence can still cause traumatic injuries that threaten the patient's ability to survive and function. Neuro-trauma surgeons work with these patients, attempting to minimize damage to the nervous system and create the greatest possible likelihood of returning to normal life. Critical care neurosurgery also deals with patients in crisis. In these cases, patients are threatened by major strokes, acute illnesses and other catastrophic neurological conditions. This often includes palliative care for patients whose condition is irreversible, but can be made more tolerable by surgical intervention.

Neuro-Oncology and Interventional Neuroradiology

Oncology is the study and treatment of cancers. Brain tumors are some of the deadliest and most difficult to deal with, and they're the province of neuro-oncologists. Neuro-oncologists devise methods of removing brain tumors while minimizing the damage to the surrounding brain tissues. The specialty makes heavy use of diagnostic radiological imaging, especially computed tomography and magnetic resonance imaging scanning. Neuro-radiologists often work with the oncologist, providing their expertise in interpreting the images. Interventional neuroradiologists go a step further, using these imaging technologies to guide miniature surgical instruments through the brain's blood vessels. They can repair damaged veins internally or seal off blood vessels that feed tumors.

Pediatric Neurosurgery

While most neurosurgical subspecialties relate to specific procedures or medical conditions, pediatric neurosurgery is centered around the needs of children. Children's bodies are physically smaller and less robust than those of adults, increasing the difficulties surgeons face. Pediatric neurosurgeons perform a wide range of procedures on their young patients, so they must have a broad grasp of neurosurgery as well as pediatrics. For example, pediatric neurosurgeons correct birth defects and treat traumatic head injuries and severe forms of epilepsy.

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