Both neurology and neurosurgery deal with the treatment of problems or diseases of the brain, nerves, muscles, and the spinal cord. Neurology is the field of medicine involved in the initial diagnosis and subsequent drug-based treatment of a neurological problem. The specialized field of neurosurgery treats a patient with a neurological condition using surgical techniques or may surgically confirm a diagnosis of a neurological disease.
A neurologist specializes in the practice of neurology, and a neurosurgeon specializes in neurosurgery. While a neurologist may perform minor surgery in the office, such as a muscle biopsy, she would never perform major surgery. Surgical treatment would be recommended by a neurologist who would refer the patient to a neurosurgeon to perform the operation. While neurology and neurosurgery are interconnected by the treatment of neurological disorders, most major hospitals separate these two disciplines into different departments.
One example of the relationship between neurology and neurosurgery is the treatment of Parkinson's disease. A patient suffering from dyskinesias and suspected of having Parkinson’s disease would first be referred to a neurologist by their primary care doctor. The neurologist would run a variety of tests to diagnose the patient and treat him with drugs to control the symptoms. A patient would also periodically see the neurologist to follow the progression of the disease and to evaluate the efficacy of the drugs being used.
If the drugs are not able to control the dyskinesias, the neurologist would refer the patient to a neurosurgeon to evaluate whether surgical treatment would help the problem. The neurologist may recommend surgery, such as a pallidotomy, or may leave the recommendation up to the neurosurgeon. Copies of all of the patient’s medical records and tests would be sent to the neurosurgeon from the neurologist’s office. The neurologist and neurosurgeon may talk prior to the patient’s appointment as well as after.
At the appointment, the neurosurgeon would talk to the patient to confirm the medical history and examine the patient to see if her diagnosis is consistent with the diagnosis of the referring neurologist. Once the best course of action is determined, the neurosurgeon would perform surgery, handle short-term, immediate follow-up care after surgery, and would send a report to and talk with the patient’s neurologist. Long-term care of the patient following surgery would revert the neurologist.
The fields of neurology and neurosurgery are connected in their effort to solve or mitigate a neurological problem, but each profession handles different aspects of the treatment. In the model of the medical profession, the neurologist is sort of similar to the primary care doctor. The neurosurgeon is the specialist, brought in temporarily to surgically improve a condition.
