Neurosurgery

from Wikipedia, the free encyclopedia

The Neurosurgery (to ancient Greek νεῦρον neuron "nerve") is a from the surgery product derived compartment and is engaged in the discovery and with the operational treatment of diseases , deformities and (consequences of) injuries and other damage to the central and peripheral nervous system . This also includes appropriate preliminary examinations, conservative treatment methods and rehabilitation .

Historical illustration: elevation of a skull impression fracture. Woodcut from Hans von Gersdorff's Feldbuch der Wundarzney (1517)

History of Neurosurgery

The first neurosurgical operations in the form of (successful, i.e. healed again) skull openings ( trepanations ) were proven as early as the Neolithic period on the basis of skeletal finds. Neurosurgical surgical procedures were first documented in detail in the work Chirurgiae libri septem , which Giovanni Andrea della Croce (1514–1575) wrote and which was published in Venice in 1573. Modern neurosurgery could only develop in the second half of the 19th century. At the beginning of the 20th century "brain surgery was not a separate subject in Germany" even if many well-known surgeons such as Ferdinand Sauerbruch and Nicolai Guleke had already dared to perform cranial operations; “In the USA, specialization was much more advanced”.

The American surgeon Harvey Cushing (1869–1939) was one of the first and most important neurosurgeons and developed many new neurosurgery techniques while working in Baltimore and Boston. He was able to reduce the mortality of brain surgery interventions by 1931 after several failures and fatal attempts for the patients from 90% to 7%. He systematically developed neurosurgery and is considered the founder of modern neurosurgery. Numerous special surgical instruments still used today can be traced back to him. Other pioneers of modern brain and spinal cord surgery were the American Walter Edward Dandy and the Swede Herbert Olivecrona . In Germany, the surgeon Wilhelm Tönnis helped neurosurgery to become independent. He was Fritz König's assistant and was sent by him to Olivecrona for further training. In 1936, König set up an independent neurosurgical department for Tönnis in Würzburg. The Central Journal for Neurosurgery , founded by Tönnis in 1936, was the only specialist journal for neurosurgery until 1943. Until the 1960s, cerebral haemorrhages caused by accidents such as subdural hematomas were mostly treated by general surgeons using trephination. In the 1970s, neurosurgery became a specialty in all of Germany.

Neurosurgery in individual countries

Germany

Neurosurgeons in D.JPG

In order to work as a specialist in neurosurgery after studying medicine in Germany , six years of further training are required. The respective state medical association is responsible for the exact mode of specialist training. The further training comprises at least four years in the hospital, the following can be taken into account:

or

Half a year must be completed in neurosurgical intensive medicine .

On December 31, 2006, 1,561 neurosurgeons were registered in Germany, 348 of whom worked in the private sector. 182 did not do any medical work. The proportion of women among working neurosurgeons was 13% in 2006.

The prices for setting up a practice are high with an estimated share capital of € 110,000 to € 150,000 plus equipment, acquisition costs € 250,000 to € 1,250,000.

Switzerland

To become a neurosurgeon in Switzerland , you have to complete a six-year training course divided into two stages.

  • 1 year in a non-neurosurgical subject (“foreign year”): general surgery or surgical sub-specialty (with the exception of neurosurgery) with participation in the general surgical emergency service, orthopedics , maxillofacial surgery , ENT, neurology, neuroradiology, neuroanatomy , neuropathology, clinical or experimental neurophysiology , experimental surgery .
  • 5 years of neurosurgery, whereby the training location has to be changed at least once for a year.

In 2006, 99 neurosurgeons were registered in Switzerland, 51 of them doctors with practice.

United States

To work as a neurosurgeon in the United States , you need seven years of residency .

  • 1 year internship (internship) in general surgery and in rotation on other surgical departments
  • 6 years in neurosurgery

Canada

To become a neurosurgeon in Canada , you must complete a six-year training course divided into two stages.

  • 2 years of surgical physiopathology and surgical basics
  • 4 years of neurosurgery

See also

literature

  • Hans Arnold , Wolfgang Bock , Karl-August Bushe , Hartmut Collmann a . a. (Ed.): Neurosurgery in Germany: Past and present. 50 years of the German Society for Neurosurgery. Blackwell, Berlin, Vienna a. a. 2001, ISBN 3-89412-482-2 .
  • Paul C. Bucy (Ed.): Neurosurgical Giants: Feet of Clay and Iron. Elsevier Science, New York, Amsterdam and Oxford 1985, ISBN 0-444-00939-6 .
  • W. Seeger , CL Geletneky: Surgery of the nervous system. In: FX Sailer, FW Gierhake (ed.): Surgery seen historically: beginning - development - differentiation. Dustri-Verlag, Deisenhofen near Munich 1973, ISBN 3-87185-021-7 , pp. 228-262.
  • Margret Liehn, Martin Brunken, Martin Weißflog, Anett Gudat: Neurosurgery , in: Margret Liehn, Brigitte Lengersdorf, Lutz Steinmüller and Rüdiger Döhler : OP manual. Basics, instruments, operating procedures , 6th, updated and expanded edition. Springer, Berlin Heidelberg New York 2016, ISBN 978-3-662-49280-2 , pp. 525-575.

Web links

Individual evidence

  1. ↑ Christoph Weißer: Neurosurgery. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1036 f.
  2. ↑ Barbara I. Tshisuaka: Croce, Giovanni Andrea della. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. 2005, p. 278.
  3. ↑ Ernst Kern : Seeing - Thinking - Acting of a surgeon in the 20th century. ecomed, Landsberg am Lech 2000, ISBN 3-609-20149-5 , p. 157.
  4. ↑ Pamela Dörhöfer: You wanted to make life easier for people with severe suffering. In: Frankfurter Rundschau. March 16, 2018, pp. 28–29 (cited), in a detailed review of the book by Ulrike Eisenberg, Hartmut Collmann , Daniel Dubinski: Verrats - Vertrieb - Vergessen. The work and fate of German brain surgeons persecuted after 1933. Hentrich and Hentrich, Berlin 2017, ISBN 978-3-95565-142-8 .
  5. ↑ Sabine Schuchart: Harvey Cushing founded modern brain surgery Deutsches Ärzteblatt 1018, Volume 115, Issue 31-32 of August 6, 2018, p. 92.
  6. ↑ Ernst Kern: Seeing - Thinking - Acting of a surgeon in the 20th century. 2000, p. 157 f.