Best Neurologist In Lucknow

Generally speaking, a neurosurgeon is a person who specializes in neurosurgery. They are medically trained professionals to treat neurological issues. More than brain surgery, they treat people suffering from back and neck pain and other issues related to the human nervous system. Neurosurgeons usually provide the prevention, diagnosis, evaluation, treatments, critical care and rehabilitation of neurological disorders. A neurologist should undergo for extensive trainings in the field. He/she should be well trained in the diagnosis and management of neurological disorders.

Neurosurgeons are usually considered to be experts in handling issues regarding brain. This fact makes people get confused with neurosurgeons as brain surgeons. Most of the people think they handle surgeries only of the brain. Neurosurgery is a complicated field and of course, it requires highly skilled professionals to handle it. There is always a high demand for the professionals in the field of neurosurgery.

During the early stages of neurosurgery, success rates were very poor and mortality rates were high. It was reduced when steroids came in to practice in the fifties. Another landmark was the introduction of operating microscope in the early seventies, which opened the floodgates of micro neurosurgery. This improved the operative field and reduced the risks of the surgery. Technological advancements paved way to new innovations like video recording which made teaching possible.

The surgical procedures could be recorded and can be used for teaching purposes also. These new inventions made micro neurosurgery very popular. Other technological landmarks during the same period in imaging and neuroanesthesiology made neurosurgery secure. In the 21st century, the face of neurosurgery has changed entirely and it is now considered as the most safe and successful field.
Neurosurgery as a specialty is about 150 years old. Prior to that General Surgeons with some interest used to operate on the brain. The invention of X rays by Roentgen was a landmark in 1890’s and X rays of the skull were done to find out some calcifications inside the skull.

Around the same time one American Surgeon called Harvey Cushing took special interest in Neurosurgery and started operating on the brains. He visited many centers in Europe and got fascinated by Syphgmomanometer, an instrument developed by Riva Rocci in Italy, to measure blood pressure. He started using it during surgeries to monitor the blood pressure and this paved the way for intra operative monitoring.

Neurosurgical procedures used to be very messy with bleeding from the bone and also from the brain. One British Surgeon called Victor Horsley invented a substance called Bone wax, a combination of Bees wax and Phenol, that could be used to control the bleeding from the bone. Incidentally he was the first person to remove a spinal cord tumor with very good results. Bone wax is used even now in all surgical procedures were the bone is cut.

The introduction of monopolar by Harvey Cushing and subsequently bipolar cautery by Leonard Mallis, made control of bleeding from brain very easy. Simultaneously neurology also made rapid progress and neuro physicians started making precise clinical diagnosis. One of the students of Harvey Cushing, Walter Dandy introduced a procedure called Pneumoencephalography, where air was introduced into the cranial cavity and X rays were taken. The air could give a double contrast and it aided in diagnosing neurosurgical conditions. But the outcome was very bad with severe wound infections and brain swelling which resulted in very high mortality. Around 1930’s one French Surgeon, Sicard introduced a procedure called Myelography. Here a contrast medium was introduced into the spinal cavity and X rays were taken. The contrast used to indirectly show tumors and aid in diagnosis.

Around the same time one Spanish Surgeon by name Egaz Moniz developed a procedure called Angiography. Here a contrast medium was injected into the blood vessels and X rays were taken. Tumours and blood clots in the brain could be detected by this procedure indirectly by seeing the shift of blood vessels in the X rays. The contrast medium used to highlight the blood vessels. This was the main modality of investigation for the next 40 odd years. The procedure itself had many side effects and many a time patients used to have huge blood clots at the puncture site in the neck.

The contrast medium used was also toxic and many drug reactions used to occur.1940s’ saw the advent of Sulphonamides and Pencillin and they had a very large role to play in the control of wound infection. The infection rate in all surgeries fell down dramatically and operative results became better, but still neurosurgeons had to battle another condition called brain swelling or brain edema. The nervous tissue used to swell up when handled and this used to produce a lot of morbidity. Steroids were invented in 1950’s and this came as a panacea for all neurosurgeons. Steroids controlled brain edema well and the surgical o utcome became much better.

Neuronavigation is the set of computer-assisted technologies used by neurosurgeons to guide or navigate with in the confines of the skull or vertebral column during surgery. It has become a ubiquitous tool in the surgical treatment of brain tumors. It helps neurosurgeons to precisely localize different intracranial pathologies by using a set of preoperative images like CT, MRI, and fMRI, PET, SPECT. The development of computer-assisted surgery was possible only after a significant technological progress especially in the area of informatics and Imagistics.

The targeting of small and deep intra cerebral lesions and choosing the best way to treat them, in order to preserve the neurological function, represent the main indications of neuronavigation.

What do you think of when you hear, “Neurosurgeon”? You probably said to yourself “Brain surgeon”. You are partly right. Actually less than half right. Neurosurgeons do operate on the brain and that is their public image. But neurosurgeons spend more than 60% of their time treating spine problems.

Neurosurgeons are medical specialists who diagnose and treat problems in the entire nervous system. That means they treat disorders of the brain, spinal cord and spinal column plus the nerves that travel through all parts of the body such as hands, legs, arms and face. They routinely see patients for low back pain, carpal tunnel syndrome, epilepsy, stroke, Parkinson’s disease, sciatica, pinched nerves in the neck, sports injuries, chronic pain and a host of other ailments.

In a statistical study done in the west to see the range of the neurosurgeons’ expertise, it was found that the commonest surgical procedures performed by them was on spine (includes neck and back disorders). This was followed by brain (includes aneurysms, tumors and head injuries), CSF shunting for hydrocephalus, peripheral nerve (includes carpal tunnel syndrome), pain-functional (includes medication pumps and deep brain stimulation) and blood vessel abnormalities (includes strokes). Another important aspect one should not forget is neurosurgeons are not simply surgeons. This is another common misconception about neurosurgeons. Their role in treating disease is far more extensive than performing surgery.

Neurosurgeons often provide or recommend non surgical care. They diagnose what is wrong and work with the patient to develop the optimal treatment plan. For example, most cases of back pain are treated with anti inflammatory medication, physical therapy and muscle relaxants. A common treatment a generation ago, surgery is now considered necessary for only a small percentage of back pain patients.