Neurology is a science that focuses its study on the abnormalities and the treatment of the nervous system which is divided into two main parts which are the peripheral nervous system and the central nervous system. The central nervous system abbreviated as CNS is further divided into the brain and the spinal cord and the peripheral nervous system abbreviated as PNS is further divided into the ganglia and the nerves which are located outside the spinal cord and the brain.
A person who studies this field in medical sciences is known as a neurologist, so basically, a neurologist is a person who or a doctor that specializes in the study and treatment of the abnormalities and diseases that affect the nervous system. Neurologist generally goes through a medical school and some other procedures before they can actually start practicing as a neurologist. The process involves:
- Going to a medical school to study the course, the period the course will last is determined by the location of the medical institution, as different countries fix the years students are to study the course and this ranges from four to six years.
- Go for and complete an internship that would last for the period determined by your country of study.
- Additional training in any neurology program is also a requirement.
The process might consume a whopping eight to ten years before one becomes a neurologist. Neurology is a very complex field of study, so a neurologist becomes a specialist in a particular field. The different fields in neurology are endovascular neurosurgery, Spinal neurosurgery, neurotrauma, neuro-immunology, skull base surgery, pituitary neurosurgery, peripheral neurosurgery, pediatric neurosurgery etc. Let’s take a brief look into some specialty and their functions.
Pediatric Neurosurgery: This part of neurosurgery focuses it studies and treatments on children related neurological diseases and abnormalities such as brain tumors, spinal tumors, hydrocephalus, head injuries etc.
Functional Neurosurgery: This is the part of neurosurgery that focuses its studies and treatment on the abnormalities of body movement causes by disorder from the nervous system, Parkinson’s and Multiple Sclerosis are two of such diseases handled by a functional neurosurgeon.
Stereotactic Neurosurgery: This is the part of neurosurgery that works on the brain by using a stereotactic ring that is attached to the patient head and used for studying the coordinates and administering treatments.
Cerebrovascular Neurosurgery: This is the part of neurosurgery that specializes in the flow of blood in the nervous system, the flow of blood to the spine and the brain and also within it. Relieving narrowed blood vessels is one of their functions.
Neuro-oncology: This field of neurosurgery is concerned with the diagnosis and treatment of cancerous tumor of the spine and the brain.
Neuroradiology: This field is concerned with the diagnosis and treatment of the fractured spine, tumor, and strokes, and they use microcatheters in the process.
Some of the nervous diseases that neurologist diagnose and administer treatments to are
Parkinson’s Disease: This occurs usually as a result of damage to the part of the brain that produces the chemical the body uses for the movement and control of the muscles of the body and this chemical produced by the brain is called dopamine.
Alzheimer’s Disease: This is a disorder that affects the chemicals that send messages between brain cells called neurotransmitters and also affects the brain cell itself. This leads to changes in behavior, memory and brain functioning.
Cerebral Palsy: This is a disorder that is caused by damages to the nervous system which leads to reduction or inability of one to control their muscles properly.
Bell’s Palsy: This is damage to the nerves of the face and it leads to the paralysis of a section of the face, unlike most nervous system diseases, the Bell’s Palsy is temporary and a majority of people tend to recover from it.
Multiple Sclerosis (MS): This is a very severe disease that occurs in the central nervous system. It occurs as a result of the damages to the protective layer of the nerve fiber called the myelin, making the nerves unable to send a signal to other parts of the entire body.
Epilepsy: This is a continuous seizure in a person as a result of the brain Condition of the individual.
Motor Neuron Disease: This is weakness one experiences in the muscle and when it advances to the very severe stage it can lead to paralysis of the body. The motor Neuron disease affects the nerve cells directly and it can also be called Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease.
Neurofibromatosis: Neurofibromatosis is a growth of a non-cancerous tumor on the nerve cells of the body. Neurofibromatosis is currently managed but not cured.
Sciatica: The adverse symptom of this is severe pain in the leg and the back and it is caused by several factors which include bone spurs, swollen muscles in one’s buttocks, spinal injury etc.
Procedures taken by a Neurisurgeon
When one visits the neurosurgeon, there is always an examining that will be done or a diagnosis that will be done in order to get to know what the patient problem is, a neurologist will typically follow one of the procedures that will be mentioned below in order to diagnose patient.
- Lumbar Puncture: This procedure is usually recommended when the symptoms of one’s illness are caused as a result of an abnormality in your system and it can be detected in the spinal fluid. The neurologist in this process uses a lumbar Puncture also known as a spinal tap to extract some cerebrospinal fluid (CSF) from a patient and run a diagnosis on it. The cerebrospinal fluid is the fluid that covers the brain and also covers the spinal cord. The lumbar puncture is mostly used for cases like meningitis, subarachnoid hemorrhage, multiple Sclerosis, myelitis, and cancers that occur in the spines and the brain.
- Tension Test: This procedure is quite easier than that of the lumbar puncture, both for the patient and the neurologist, because it involves the use of injection. The neurologist injects Tension into the body and studies the traction of the patient after the injection. This procedure helps neurologist with patients that have myasthenia gravis.
- Electroencephalogram (EEG): This procedure involves the application of electrodes to your scalp which measures all the necessary electrical functioning of the brain.
- Computed Tomography (CT) Scan: A CT scan also known as computed Tomography makes cross-sectional pictures of a patients body using different types of computers one of which is the X-ray machine that rotates. The computed Tomography scan show in its result the bones in all parts of the patient’s body, blood vessels and tissues. This scan visualizes the heart, shoulders, chest, head, spine, abdomen and kneel. The typical process of the computed Tomography involves the patient lying flat in a machine that is cylindrical in shape and in this process several x-rays are taken.
Magnetic Resonance Imaging: Mainly of the head, Magnetic Resonance Imaging is a noninvasive and painless procedure that generates complete pictures of your brain stem and the brain itself. The magnetic resonance machine produces pictures by making use of radio waves and a magnetic field. The magnetic resonance imaging is considered to be one of the most effective scanners that detect an error in the internal parts of humans because it is able to produce 3D images of the internal organs of the human body.
- Positron Emission Tomography: Basically for the brain, it is a test conducted by a neurosurgeon to check the functioning of the brain. This works easily, the procedure for the diagnosis is simply getting radioactive tracers attached to glucose and absorbed in the body, the brain needs glucose for it’s functioning, the part of the brain that is active consumes more glucose than other parts that are not active in this process, when the brain is scanned with the Positron Emission Tomography, it gives the doctor visuals on the part of the brain that is functioning and that which is not functioning properly.
- Brainstem Auditory Evoked Response: This diagnosis is done by attaching electrodes to the earlobes and the scalp of patients in order to test their inability to hear which might be caused by a brainstem tumor.
- Carotid Duplex (carotid ultrasound): Water soluble gel is put on top of the upper layer of the skin of a patient’s body where the transducer will also be placed, the function of the gel is to transmit sounds to the surface of the skin. When the ultrasound is on, the picture of the pulse waves and the carotid artery are displayed, this is done in order to locate blood clots, plaque and general blood flow problems found in the carotid artery of the human body.
- Discography: The neurosurgeon uses this diagnosis to ascertain if the source of pain is from the intervertebral discs located in the spinal column. Magnetic Resonance Imaging and Computed Tomography can actually detect abnormalities in the spine but cannot really decipher if that very abnormality is the one that causes the pain experienced by the patient, hence, discography is used to attain facts before surgical operations are begun on a patient body. If the report of the discogram comes out negative, then the intended surgical operations would not have solved the patient’s problem. The discography involves the patient lying on their back after application of medication that would help patients relax and also medications of antibiotics and a cervical spine discography is conducted, they further lye by their side for lumbar spine and thoracic discography. A small needle is sent to the suppose affected disc by the doctor with the help of the X-ray, when the needle is at the right spot a little quantity of contrast dye is injected into the disc, this process can be done for multiple discs, after this process the patient is moved to the Computed Tomography machine for additional images to be taken.
- Electromyography (EMG): The test is basically for diagnosis of the nerves in the legs and the arms which are peripheral nerves, this diagnosis can locate a pinched nerve and determine the severity of the pinched nerve. The electromyography helps to measure the electrical activities that takes place in the muscles of the body, the muscles of the body are powered by electrical signals from nerves that are functioning properly. In recording electric signals from arms and legs, the neurosurgeon inserts a tiny needle into the suspected muscle to check if the impulses sent to the muscles are not adequate enough.
- Myelogram: This diagnosis is used majorly for the spinal cord and the spinal canal. In accordance with the topical anesthetic application, spinal fluid gotten through the process of lumbar puncture, the spinal fluid, and the contrast dye mixes up in the spinal sac, this enables it to show up on x-rays. The myelogram is an older version of scan that was used before the introduction of the magnetic resonance imaging and the Computed Tomography. It is still in use for some cases with special issues like patients that have metal plates in the spines.
- Nerve Conduction Study: This diagnosis is usually done together with the electromyography diagnosis. It makes use of electrical stimulation of nerves and measures the nerves strength to transmit impulse, and this, in turn, determines the functionality of the studied nerve. The procedure for this diagnosis involves placing electrode patches in the region of the suspected nerve, then it is stimulated by small electrical current at a particular spot, a functional nerve transmits this signal with speed and it is then captured by the electrode placed on the nerve, on the other hand, a damaged or malfunctioning nerve would not transmit the signal properly.
There are several other diagnostic procedures done by the neurologist or neurosurgeon before they administer treatments or perform surgical operations.