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Neurology and Neurosurgery: Is there a difference?

Neurology and Neurosurgery: Is there a difference?. Daniel Boedeker, M.D. Neurosurgery Specialists. Neurology or Neurosurgery. There is a lot of confusion with whether a patient needs a Neurologist or a Neurosurgeon, and for good reason.

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Neurology and Neurosurgery: Is there a difference?

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  1. Neurology and Neurosurgery: Is there a difference? Daniel Boedeker, M.D. Neurosurgery Specialists

  2. 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?

  3. 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

  4. 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: Parkinson’s, Alzheimer’s, Seizure disorder, etc.

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

  6. 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

  7. 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

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

  9. 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.

  10. Examples • Patient is discharged to follow up with neurosurgeon • Follow up CT’s 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

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

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

  13. 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.

  14. 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

  15. Symptoms/Treatment • Patient’s 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.

  16. 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

  17. 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

  18. 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

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

  20. 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

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

  22. ANY QUESTIONS?

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