Neurology%20and%20Neurosurgery:%20Is%20there%20a%20difference?

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Neurology and Neurosurgery Is there a difference?

• Daniel Boedeker, M.D.
• Neurosurgery Specialists

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Neurology or Neurosurgery

• There is a lot of confusion with whether a
  patient needs a Neurologist or a Neurosurgeon,
  and for good reason.
• Treatment of a lot of the same body parts, issues
  and symptoms.
• When is a neurologist needed and when is a
  neurosurgeon the one to call?

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Neurology

• Medical doctor specializing in diagnosis and
  treatment or management of certain conditions of
  the brain and nervous system
• May have specialized training in one area or
  another

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Neurology

• In some instances, a neurologist may take on the
  role of primary care physician if a patient is in
  need of continuing and extensive treatment for a
  condition
• Examples Parkinsons, Alzheimers, Seizure
  disorder, etc.

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Neurology

• Common ailments that lead to a neurology
  consultation
• Stroke
• Headaches
• Pain
• Seizures
• Brain or spinal cord injuries

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Neurology

• Often confused with neuroSURGERY and vice versa
• Often treat similar problems and body parts
• Many patients need a neurology work up prior to
  seeing a neurosurgeon depending on the diagnosis

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Neurosurgery

• Neurosurgeons treat conditions of the brain and
  spinal cord as well
• Head injury
• Fracture
• Spinal cord injury
• Tumor of the brain or spine
• Aneurysm
• Bleed

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Neurosurgery

• Neurosurgeons DO NOT treat
• headaches with no neurosurgical cause
• Vertigo
• Stroke
• Post- Concussive Syndrome
• Seizures without a neurosurgical cause

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Examples

• Male 33 years old hit in the head on the job
• Brief loss of consciousness
• ER visit- Neurosurgeon is called
• CT is performed to assess for bleed or fracture.
  CT shows a small fracture of the skull and small
  intracranial hemorrhage.

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Examples

• Patient is discharged to follow up with
  neurosurgeon
• Follow up CTs are performed the following visits
• After two months, the CT is normal, meaning no
  bleed and no fracture
• Patient calls two weeks later complaining that he
  had a seizure but the CT done in the ER was
  negative

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Examples

• Who does patient need to follow up with?
• NEUROLOGY
• management of any symptoms after the accident
  that are not neurosurgical

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Examples

• Patient in MVA
• Complains of headaches
• Diagnostic testing is negative for any fractures,
  bleeds or trauma
• Patient needs NEUROLOGY

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Examples

• Patient hit in the head on the job
• Wife calls us to make an appointment because he
  is acting strange.
• Patient needs work up by Primary Care and/or
  Neurology to determine whether there is anything
  Neurosurgical causing symptoms.
• Only then will we need to see this patient.

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Examples

• Patient has a seizure
• Diagnostic testing to be done to determine
  whether seizure was caused by something
  neurosurgical such as bleed or tumor
• Seizures can be caused by a variety of factors
  unrelated to neurosurgery so it is important that
  patient has a full work up to determine the cause

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Symptoms/Treatment

• Patients symptoms can many times be assessed by
  a number of qualified physicians. However, unless
  it is something that is NEUROSURGICAL, neurology
  is the best course to take.

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Symptoms/Treatment

• Vertigo (dizziness)
• This is many times thought to be neurosurgical
  but is actually a condition treated by neurology
• Involves the inner ear, sensory pathways and the
  brain
• No surgery or neurosurgical management involved
• NEUROLOGY

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Symptoms/Treatment

• Headaches
• This is neurosurgical if headaches are
  accompanied by a fracture, bleed, tumor or other
  neurosurgical condition
• Headaches can stem from several causes and are
  best managed by
• NEUROLOGY

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Symptoms/Treatment

• Post- Concussive Syndrome
• We receive many requests to consult on this
  diagnosis
• Involves headaches and many times behavioral
  changes
• Treatment includes treating the symptoms
• NEUROLOGY

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Symptoms/Treatment

• Memory Loss
• This could be caused by a number of factors
• Often after a head injury or concussion
• Treatment by NEUROLOGY

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Neurosurgery

• We use many tests to determine whether something
  is indeed neurosurgical
• MRI or CT to check for fracture, bleed, tumor,
  aneurysm
• All are neurosurgical issues that may or may not
  be able to be treated surgically

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Neurosurgery

• Conditions that may need immediate treatment by
  neurosurgery
• Brain bleed/hematoma
• Tumor
• Severe herniated disk or spinal fracture
• Aneurysm

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ANY QUESTIONS?