Neurologists vs. Neurosurgeons

With so many medical specialties, it’s important to understand what type of specialist to see when trying to get diagnosed for a medical condition. A neurosurgeon and a neurologist both specialize in the treatment of medical problems affecting the central nervous system. The central nervous system controls most of the functions of the body and mind, consisting of the brain and spinal cord.

Neurologist vs Neurosurgeon

What is a neurologist?

A neurologist treats diseases and conditions of the brain and nervous system, but they do not perform surgery. They are trained to diagnose and treat a wide range of conditions, including but not limited to:

1. Neurological disorders: Such as epilepsy, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, and other forms of dementia.
2. Neuromuscular disorders: Such as muscular dystrophy, myasthenia gravis, and peripheral neuropathy.
3. Headaches and migraines: Including chronic and severe forms.
4. Stroke: Both ischemic (caused by a blood clot) and hemorrhagic (caused by bleeding).
5. Movement disorders: Such as tremors, dystonia, and restless leg syndrome.
6. Seizure disorders: Including epilepsy and other types of seizures.
7. Neurodevelopmental disorders: Such as autism and attention-deficit/hyperactivity disorder (ADHD).
8. Neurological injuries: Such as traumatic brain injury and spinal cord injury.

Neurologists may perform a variety of tests and procedures to help diagnose and manage these conditions, including neurological examinations, imaging studies (like MRI and CT scans), electroencephalograms (EEGs), electromyography (EMG), and nerve conduction studies.

It’s worth noting that neurologists often work closely with other healthcare professionals, including neurosurgeons, physical therapists, occupational therapists, and speech therapists, to provide comprehensive care for patients with neurological conditions.

What is a neurosurgeon?

One common myth is that neurosurgeons are just brain surgeons. However, according to the American Association of Neurological Surgeons (AANS), they typically spend a lot more time on spine conditions and procedures than brain conditions and procedures.

Common conditions neurosurgeons treat are back pain, neck pain, sciatica, herniated disks, degenerative diseases of the spine, cerebrovascular disorders, brain and spinal tumors, and stroke. In addition, since the nervous system extends from your brain to your spine and your nerves branch out into your entire body, they treat conditions that present symptoms in one part of your body that are actually related to a problem in the central nervous system. For example, carpal tunnel symptoms are sometimes related to a problem in your cervical spine (neck area).

Although they can perform very complex surgeries, neurosurgeons typically use non-operative treatment plans before performing surgery. If surgery is required, minimally invasive techniques are used whenever possible. Neurosurgeons are also on call for emergency room physicians when a patient has trauma involving the brain and spinal cord.

What do neurologists and neurosurgeons have in common?

Neurologists and neurosurgeons have several things in common including:

1. Specialization in Neurology: Both neurologists and neurosurgeons specialize in the field of neurology, which focuses on the diagnosis and treatment of disorders related to the nervous system.

2. Medical Doctors: Both neurologists and neurosurgeons are medical doctors who have completed medical school and obtained a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree.

3. Advanced Training: After completing medical school, both neurologists and neurosurgeons undergo additional, extensive training in their respective fields.

4. Diagnostic Skills: Both professions are skilled in conducting neurological examinations, interpreting imaging studies (like MRI and CT scans), and performing specialized tests to help diagnose neurological conditions.

5. Collaborative Approach: Neurologists and neurosurgeons often work closely together in the care of patients with complex neurological conditions. They collaborate to develop comprehensive treatment plans and determine whether surgical intervention is necessary.

DEGREE AND TRAINING

Neurologists undergo four years of pre-medical education at a college or university, four years of medical school resulting in an MD or DO degree, one year of internship, and at least three years of specialty training in a neurology residence program. Some neurologists elect to take additional training in an area of interest such as stroke, movement disorders, or sleep medicine.

A neurosurgeon’s training is the longest training period of any medical specialty. In addition to four years of pre-medical education, four years of medical school, and a year of internship, their residency is five to seven years. After that, many pursue a fellowship to specialize in an area such as spine, pediatric neurosurgery, or peripheral nerve surgery.

FINDING THE RIGHT SPECIALIST

There is some overlap between these two types of specialists and the conditions they treat. Sometimes these doctors work collaboratively; a neurologist can refer their patients to a neurosurgeon when surgery is required (such as for a brain tumor) and then the patient returns to the neurologist for long-term management. If you have a condition or symptoms that you think require a brain and spine specialist, ask your primary care physician about which type of specialist to see. Our multidisciplinary team of physicians at The Center are equipped with the latest technologies and have the experience to treat any injury or condition that affects your musculoskeletal system.

Neurosurgeon at The Center, Dr. Ray Tien, explains the differences between a neurosurgeon and a neurologist in the video below.

VIDEO TRANSCRIPTION:

“I think one of the common misperceptions about neurosurgery is that our professions share some similarities with neurology.

“The difference is that neurosurgeons deal with surgical issues related to the brain and spine, whereas neurologists often deal more with nonsurgical, degenerative issues related to neurological problems. So for instance, Alzheimer’s disease – it’s not a medical condition that a neurosurgeon can treat, but neurologists will evaluate those types of conditions.

“Whereas herniated discs in the lumbar spine, that’s typically not a condition that a neurologist can treat. It usually falls within the neurosurgical profession.”

Who Should You Visit First: A Neurologist or a Neurosurgeon?

The decision of whether to visit a neurologist or a neurosurgeon first depends on the specific nature of your symptoms and the suspected or diagnosed neurological condition. Here are some general guidelines:

Visit a Neurologist First if:

1. You are experiencing neurological symptoms: If you’re dealing with symptoms like headaches, seizures, numbness, weakness, difficulty with coordination, or other neurological issues, it’s often best to start with a neurologist. They specialize in diagnosing and managing a wide range of neurological conditions and can determine if surgical intervention is necessary.

2. Your condition does not require immediate surgery: If your condition does not require urgent surgical intervention, a neurologist is typically the first point of contact. They will conduct a comprehensive evaluation, order appropriate tests, and initiate non-surgical treatments if needed.

3. You have been referred by a primary care physician: If your primary care doctor suspects a neurological issue, they will likely refer you to a neurologist for further evaluation and diagnosis.

4. You have a known or suspected neurological disorder: If you have already been diagnosed with a neurological condition (such as epilepsy, multiple sclerosis, or Parkinson’s disease), or if you suspect you may have one, a neurologist is usually the initial specialist to consult.

Visit a Neurosurgeon First if:

1. Your condition requires urgent surgical intervention: If you have a neurological emergency, such as a severe head injury, a spinal cord injury, or a brain hemorrhage, it’s crucial to seek immediate attention from a neurosurgeon. They are trained to perform emergency surgeries and interventions.

2. Your condition has been specifically identified as surgical: If you have a known neurological condition that is likely to require surgery, or if you have received a recommendation for surgical treatment from a neurologist or another healthcare provider, it may be appropriate to see a neurosurgeon directly.

3. You have a complex neurological issue that may require surgery: In some cases, particularly for complex or difficult-to-treat neurological conditions, it may be beneficial to consult with a neurosurgeon early in the diagnostic process to explore potential surgical options.

Ultimately, in many cases, the decision of whether to see a neurologist or a neurosurgeon first will be guided by a referral from a primary care physician or another specialist. It’s important to communicate with your healthcare provider about your symptoms and concerns so they can help guide you to the most appropriate specialist for your specific situation.

How Neurologists and Neurosurgeons Work Jointly Through Patient Care

Neurologists and neurosurgeons sometimes work together to provide comprehensive care for patients with neurological conditions. This collaborative approach ensures that patients receive the best possible care, combining the expertise of both specialties. Here’s how neurologists and neurosurgeons work jointly through patient care:

1. Consultation and Referral: When a patient presents with a neurological issue, they may initially see a neurologist. The neurologist will conduct a thorough evaluation, which may include a neurological examination, review of medical history, and ordering of diagnostic tests. If surgical intervention is deemed necessary, the neurologist may refer the patient to a neurosurgeon.

2. Case Discussions and Treatment Planning: Neurologists and neurosurgeons often engage in discussions about complex cases. They review the patient’s medical history, examination findings, and diagnostic test results to collaboratively determine the best course of action. This may involve deciding whether surgery is the most appropriate treatment or if non-surgical interventions should be pursued.

3. Preoperative Assessment: Before surgery, the neurologist plays a crucial role in preparing the patient for the procedure. They may conduct preoperative assessments to ensure that the patient is medically optimized and able to undergo surgery safely. This may involve managing any underlying medical conditions and adjusting medications as needed.

4. Intraoperative Collaboration: During surgery, neurologists and neurosurgeons work closely together in the operating room. The neurosurgeon performs the surgical procedure, while the neurologist may be present to provide expertise on neurological anatomy and function. This collaborative effort ensures that the surgery is conducted safely and effectively.

5. Postoperative Care and Follow-Up: After surgery, the neurosurgeon takes the lead in managing the patient’s immediate postoperative care, including monitoring for any complications and overseeing the recovery process. The neurologist remains involved, providing input on neurological status and helping to manage any ongoing neurological issues.

6. Long-term Management: In cases where a patient requires ongoing care for a neurological condition, the neurologist and neurosurgeon continue to work together. They collaborate on long-term treatment plans, which may include medication management, rehabilitation, and periodic follow-up visits to monitor progress.

7. Multidisciplinary Team Collaboration: In complex cases, neurologists and neurosurgeons often work with other healthcare professionals, such as radiologists, anesthesiologists, physical therapists, and occupational therapists, to ensure comprehensive care for the patient.

8. Open Communication: Effective communication between neurologists and neurosurgeons is essential for successful patient care. They regularly share updates on the patient’s condition, treatment progress, and any changes in the care plan.

By combining their specialized knowledge and skills, neurologists and neurosurgeons provide a holistic approach to patient care, addressing both non-surgical and surgical aspects of neurological conditions. This collaborative effort ultimately leads to the best possible outcomes for patients.

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