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Neurosurgery - what is it? Neurosurgeon: what he does and what diseases he treats. Nervous system and the needs of neurosurgery.

Neurosurgery is a very fascinating, but at the same time difficult branch of medicine. As you know, all diseases are caused by nerves. There is truth in this statement, given that the brain controls all processes in human body. In adults, only 10-15% of the total brain capacity is used. Work on eliminating diseases of the central nervous system (CNS) is complex, scrupulous and very responsible. After all, any mistake in carrying out an operation can ruin a human life.

Who is a neurosurgeon

A neurosurgeon is a highly qualified specialist who diagnoses and treats diseases of the brain, spinal cord, and peripheral nervous system. In total, training in this craft takes 8-10 years. To train a good operating neurosurgeon, you need to spend about 10 more years, and the doctor himself must have the following qualities:

high erudition in the field of pathology of the nervous system;
deep knowledge of anatomy, histology, physiology, pathological physiology person;
resistance to stress;
thoroughness;
the ability to think soberly, quickly weigh the pros and cons;
determination;
responsiveness;
sympathy;
ability to work even with unpromising patients;
thirst for constant self-development, because neurosurgery has not been studied at all;
high precision in hand movements;
common sense must precede the movements of the fingers, because the cost of a mistake is very high.

In addition to such character qualities, a neurosurgeon must have excellent health, vision, and constantly maintain physical fitness.

In neurosurgery the following subsections are distinguished:

neuro-oncology;
pediatric neurosurgery;
neurotraumatology;
vascular diseases of the central nervous system;
functional neurosurgery;
psychosurgery;
spinal cord surgery;
surgery of the peripheral nervous system;
purulent-septic surgery.

A neurosurgeon treats both acute and chronic conditions.

What complaints are addressed to a neurosurgeon?

Headache and dizziness - frequent symptoms for pathology of the central nervous system (photo: www.gohealth.com.ua)

Important! The range of central nervous system diseases is quite wide, and not every person can independently determine which specialist can help if complaints arise.

Appearance the following symptoms requires immediate consultation with a neurosurgeon:

a headache that does not go away after taking painkillers, is constantly disturbing, and has a bursting character;
constant nausea;
indomitable and causeless vomiting, which is not controlled by the use of antiemetic medications;
dizziness when lying down and standing that cannot be treated;
sharp deterioration vision. A person complains that he cannot see everything that is to his right or left;
nystagmus (pendulum-like and involuntary movements eyeballs);
strabismus that appeared with in full health;
protrusion of one eyeball outward;
sudden loss speech, memory, articulation;
gait disturbances;
severe pain in the spine, which hinder movements in the limbs and torso;
feeling of numbness in the legs and arms;
back pain and the appearance of disorders in the sexual sphere;
the appearance of sudden seizures;
various injuries that are accompanied by damage to the brain or spinal cord.

Important! Many patients do not pay attention to constant headaches. But quite often such a banal symptom, if it continues for weeks or months, indicates a serious organic pathology of the brain.

It should be noted that people need to take into account three main symptoms, the simultaneous occurrence of which requires consultation with a neurosurgeon: severe headache, vomiting and sudden loss of consciousness.

What diseases does a neurosurgeon treat?

An experienced doctor should treat diseases of the nervous system. Neurosurgeons treat conservatively or perform surgical interventions for the following diseases:

CNS tumors. Any brain tumor, even benign, is considered obviously malignant. This is because all neoplasms increase intracranial pressure. Symptoms depend on the affected area;
Tumors of the peripheral nervous system appear anywhere - abdominal and pleural cavity, limbs, retroperitoneal space;
consequences of the past infectious diseases. Meningitis, encephalitis, and neuritis can leave behind an adhesive process between the meninges. In this case, the circulation of the spinal fluid is disrupted, and pain and neurological symptoms are associated;
Skull injuries occur after road accidents, blows with a blunt or sharp object. This is fraught with the development of hemorrhage in meninges and brain tissue. Headaches, vomiting, loss of consciousness, nystagmus, and gait disturbances appear;
spinal cord injuries, peripheral nerves for limb injuries. Falls from heights, jumping into water, and blows from sharp objects often damage the vertebrae, thereby compressing the nervous tissue. Paresis or paralysis of the lower extremities and permanent dysfunction may occur pelvic organs;
epilepsy is characterized by sudden seizures that the patient does not remember. The attacks are so severe that breathing may stop;
Cerebral aneurysms are characterized by suddenness. When an aneurysm ruptures, the patient suddenly loses consciousness and falls into a coma. The outcome in the vast majority of cases is fatal;
intervertebral hernias of different parts. Considered life-threatening cervical region, because squeezing medulla oblongata leads to cessation of breathing and cardiac activity;
brain abscesses after infectious diseases. Symptoms depend on the affected area.

In pediatric neurosurgery, diseases are similar to those in adults, but in addition pediatrician is undergoing treatment congenital anomalies: nonunion of the neural tube, vertebral hernia, hydrocephalus (excessive accumulation of fluid in the membranes of the brain), brain cysts. Such diseases are difficult to treat, and rehabilitation period lasts for the rest of your life.

How does an appointment with a neurosurgeon proceed?

After problems with the nervous system appear, a person should immediately seek help from a neurosurgeon.

The doctor adheres to the following sequence in examining the patient:

collection of complaints;
medical history;
finding out the causes of the disease;
local examination of the patient using a neurological hammer;
examination for the presence or absence of reflexes: knee, elbow, in the Achilles tendon area, wrist joint;
checking for symptoms of inflammation of the spinal membranes if there are signs of infectious meningitis, especially in children;
studying the patient’s stability in the Romberg pose (arms straightened in front of you, palms down, legs together); if a person begins to stagger or leans to the side, then there is definitely a brain pathology;
test for walking in a straight line; if an adult cannot walk straight along a line, this indicates a problem with the cerebellum.

Patient examination and results obtained functional tests help the doctor make the correct diagnosis. If ambiguous conclusions are obtained, then it is necessary to resort to more accurate instrumental studies.

Tests ordered by a neurosurgeon

In addition to the tests performed, the neurosurgeon must prescribe the following studies to exclude or confirm pathology of the nervous system:

general blood and urine analysis;
magnetic resonance imaging (MRI) or computed tomography(CT) of the skull, spine, areas of peripheral nerve damage;
encephalography - recording on film electrical impulses that occur in the brain;
puncture of the membranes of the spinal cord (spinal puncture) in case of hemorrhage or suspected infectious meningitis;
angiography - X-ray examination cerebral vessels using a contrast agent;
ultrasound examination(ultrasound) of cerebral vessels;
myelography is an x-ray examination of the spine and spinal cord using a contrast agent, which is administered during a spinal puncture.

After receiving the research results, the neurosurgeon determines the treatment and approximately sets the terms of rehabilitation.

Operations performed by a neurosurgeon

Different branches of neurosurgery require specific treatment approaches. For example, radicalism in tumor removal is embedded in the system of work in neuro-oncology. However, it is very important that after the operation the person is able to care for himself independently and avoid paralysis or loss of social qualities (changes in behavior, memory, consciousness).

Depending on the cause of the disease, neurosurgeons perform the following surgical interventions:

craniotomy. After detecting a pathological focus, the doctor “cuts out” part of the skull bone with special tools. The operation is performed for hematomas, bone fractures, brain tumors;
shunting. Often, neurosurgeons use a drainage tube to connect the subarachnoid space (the ball of blood vessels that covers the spinal cord) with abdominal cavity in children who suffer from hydrocephalus (excessive accumulation of fluid in the brain). This way you can relieve increased intracranial pressure;
removal of the hemisphere (one half) of the brain is indicated for gunshot wounds and large tumors. This is a desperation operation, but there are cases where patients survive with minor neurological changes;
Reconstructive surgery on the skull is performed after trepanation, 6-12 months later. The hole is covered with a titanium plate to prevent damage to brain tissue;
deletion intervertebral hernia endoscopically, laser, coagulator;
osteosynthesis (comparison of bone fragments) with metal structures of the vertebrae for fractures and dislocations;
restorative microsurgery at the intersection of nerve trunks, bundles and plexuses - neurorhaphy;
Stereotactic radiosurgery is a branch of neurosurgery that requires complex mechanical head stabilizers to use radiation. After mathematical calculations, a beam of gamma rays acts on a hard-to-reach brain tumor, which destroys the tumor.

Brain surgery is very dangerous for the patient's life. Therefore, neurosurgeons are required to have high precision in movements, accurate diagnosis and extensive experience in treating such diseases.

Problems with the spine or nervous system may appear suddenly, and the person should be aware of correct behavior in such situations.

for severe headaches, you need to take an anesthetic (Nimesil, Nimid) 1 sachet per 100 ml of water orally. If it does not help, you should immediately call a doctor;
if your head starts to feel dizzy, you should immediately lie down on the floor, turning to either side;
if repeated vomiting occurs at home, you can inject Osetron 4 ml intramuscularly, and if it doesn’t get better after 30 minutes, call an ambulance;
In no case should you “set” the vertebrae when intervertebral hernias, even if the doctor suggests doing it;
sharp turns of the neck during a massage are fraught with rupture of ligaments and damage to the spinal cord;
frequent pressure surges up to 200/100 mmHg. Art., constant headaches may indicate a brain tumor. In this case, you need to consult a neurosurgeon;
It is strictly forbidden to jump into the water with your head if a person does not know the reservoir. Otherwise, you can get stranded and break cervical vertebrae;
in a car you must use head restraints, because in any accident without a head restraint, dislocation of the cervical vertebrae and compression of the spinal cord may occur;
when performing heavy physical activity, you need to first do a warm-up to warm up your muscles and protect yourself from injury.

The advice of a neurosurgeon is useful for people who lead an active lifestyle, use a car, or play sports. Caring for the nervous system will reciprocate in old age.

The surgical discipline, which has become a separate medical branch, is called neurosurgery. Her areas of interest include diseases of the nervous system that require surgical intervention. These are pathologies of both central and peripheral parts.

The main goal of neurosurgery is to accurately diagnose and provide effective surgical intervention for any lesions of the central nervous system and PNS.

History of neurosurgery

It is generally accepted that neurosurgery is a relatively young field of medicine, which became independent no more than a hundred years ago. At the beginning of the 20th century, only a few, very experienced and skillful surgeons dared to operate on the brain, although ancient monuments claim that such surgical interventions took place in the distant past.

Between the 10th and 11th centuries, Kievan Rus, unknown healers tried to repeat this practice. This is confirmed archaeological finds mid 20th century. The remains of people with traces of such an operation were buried on the territory of Belaya Vezha (an ancient Slavic city).

Speaking about the development of domestic neurosurgery, we can mention Russian military hospitals of the 18th century, which were fully equipped with instruments for craniotomy. Russian surgeons were knowledgeable about surgical techniques and skillfully applied them, which even helped to heal very complex brain injuries.

The famous commander Kutuzov in 1774, during a serious battle near Alushta, was wounded by a bullet in the head, which missed right through. Somewhat later, 14 years later, he received a second severe brain injury, which was treated by surgeon E.O. Mukhin (teacher N.I. Pirogova). And although that neurosurgery can hardly be called perfect, Mukhin managed to do everything possible to save Kutuzov from death, and at the same time preserve his health and military abilities.

Mukhin's capable student Pirogov continued his practice and laid the foundations of modern neurosurgery.

The first domestic department of neurosurgery was opened at the end of the 19th century with the participation of academician V.M. Bekhterov. But the growth of neurosurgical knowledge and the field itself is associated with Burdenko and Polenov.

Types of neurosurgical operations

All surgical interventions on the nervous system organs can be divided into:

Radical operations are operations during which pathological formations in the brain are removed or a normal anatomical appearance is restored (reconstruction for skull fractures). Used for hematomas, abscesses and brain tumors.
Palliative are interventions that guarantee not the cure of the patient, but the easing of the symptoms that worsen it general condition. For example, for an inoperable tumor, you can create new way for the outflow of cerebrospinal fluid filling the ventricles of the brain.

Speaking of urgency surgical intervention, then they are:

Planned - performed if surgical treatment is necessary according to a doctor’s indication;
Emergency - a good reason for urgent intervention may be a traumatic hematoma, acute occlusion of the cerebrospinal fluid pathways and impaired circulation of the cerebrospinal fluid.

Types of neurosurgical operations:

Stereotactic is an improved type of surgery that is used for the brain, without craniotomy. Instead, it is accessed by making a small burr hole. Then comes the introduction special tool to a precisely defined area of the brain.
Endoscopic are interventions that are carried out using endoscopes, distinguished by their rigid and flexible structure. They are actively used to operate on the ventricles of the brain.
Radiosurgery is the effect on the affected area of the brain through spatial orientation and clearly directed radiation radiation.
Endovasal is a surgical treatment method used for vascular diseases of the brain. Using special catheters, various occlusion devices are introduced into the vascular system, and this happens under x-ray control.

Neurosurgical methods of instrumental research

When to contact

Consultation with a neurosurgeon is mandatory for those people who suspect the appearance of tumors or other formations in the spinal cord or brain. The patient may also be referred to a similar specialist for examination for osteochondrosis and vertebral hernia.

Patients diagnosed with epilepsy, infectious lesions of the nervous system, or abnormal development her authorities are required to urgently visit.

Modern neurosurgery

The field of knowledge of modern neurosurgery is very extensive. Current problem among patients today are osteochondrosis and vertebral hernias. Fortunately, scientists have found a minimally invasive version of pinpoint surgery using endoscopy.

Cases of strokes are no less common among the population; for this purpose, experts have developed vascular surgery, which made it possible to successfully reconstruct disorders in the cerebral circulation.

One of significant achievements Surgical treatment of epilepsy is considered possible.

Neurosurgical diseases

All neurosurgical pathologies are divided into 3 types of diseases:

The pathological process is caused by damage to neurons in the brain tissue;
Pathological process accompanied by a change vascular system brain;
A pathological process that results in damage to the meninges.

But, unfortunately, in some cases the simultaneous presence of several groups of pathological changes in the structure of the nervous system may occur.

Common neurosurgical diseases:

More about neurosurgery

The number of newly diagnosed brain tumors is 10 - 15 cases per year per 100,000 people
Brain tumors account for 6% of all neoplasms in the body.

TO risk factors, contributing to the occurrence of tumors of the nervous system include previous traumatic brain injury, some industrial intoxications, a history of X-ray irradiation of the head, and exposure to high-frequency currents.

Tumors of the nervous system are characterized by sexual dimorphism. Medulloblastomas and germinal tumors are more common in men, while meningiomas and neuromas are more common in women.

At the core tumor growth lies the damage genetic material cell, leading to disruption of its growth control. The nature of the genetic defect (or defects) determines the type of tumor.

Histological classification of tumors.

1. Neuroepithelial tumors (ependymoma, glioma, oligodendroglioma).
2. Meningeal tumors (meningiomas).
3. Metastatic tumors.
4. Pituitary tumors (pituitary adenomas).
5.Tumors cranial nerves(acoustic neuroma, etc.).
6. Vascular tumors.
7.Disembryogenic.

The concept of malignancy in relation to brain tumors.

1. By character clinical course– all brain tumors are malignant, because they lead to death due to hypertension and brain dislocation. There are fast-growing tumors (gliomas, metastases, glioblastomas, adenocarcinomas, etc.) and relatively slow-growing ones (meningiomas, adenomas, etc.). This division of brain tumors is quite arbitrary, because The location of tumor growth is also important.
2. By histological structure – depending on the histological features detected by microscopy.

Brain Tumor Clinic.

One of the main features of brain tumors is that they develop in a strictly limited space of the cranial cavity, which sooner or later leads to damage to both parts of the brain adjacent to the tumor and parts of the brain remote from it.

Compression or destruction due to tumor infiltration of adjacent brain tissue causes the appearance of primary(so-called focal, local, local, nest) symptoms. Dysfunction of brain structures relatively close to the tumor, which occurs as a result of edema, local hemodynamic disturbances, certain types of dislocations and other reasons, leads to the appearance of additional groups of local symptoms.

As the disease progresses, cerebral symptoms, developing as a result of diffuse cerebral edema, generalization of hemodynamic disorders and the appearance of intracranial hypertension (intracranial pressure in an adult is normal during a lumbar puncture in the supine position is approximately 10-15 mm Hg (120-190 mm water column).

However, when the tumor is localized in a “silent”, functionally insignificant, area of the brain, there may not be such a sequence of symptoms, and the disease debuts with general cerebral symptoms, while focal symptoms may be absent altogether. 1. Headache- is most often a general cerebral symptom, but can also be focal in brain tumors associated with the dura mater, which is richly innervated by sensory fibers.
2. Vomiting- is often a general cerebral symptom.
3. Visual impairment– often occurs with pituitary adenomas.
4. Dysfunction of cranial nerves– impaired sense of smell, impaired movements of the eyeballs, pain and/or numbness on the face, paresis of the facial muscles, hearing loss, imbalance, swallowing disorders, taste disorders, etc.
5. Focal symptoms- expression and character focal symptoms is largely determined functional role affected areas (movement disorders, paralysis, sensory impairment, epileptic seizures, speech impairment, intellectual and mental disorders, various hallucinations, blurred vision, hyperkinesis, pain, autonomic and hormonal disorders, impaired coordination). All patients with first-time epileptic seizure CT or MRI of the brain is indicated to exclude a space-occupying lesion in the brain.

The clinical picture of intracranial hypertension with its slow increase appears vague, more often “morning” headaches, often at the height of the headache is noted vomit. The earliest symptoms of slowly progressive intracranial hypertension in adults include prolongation of the venous phase of blood circulation during fluorescein angiography of the fundus (the capillary and arterial phases change only with a pronounced increase in pressure in the cranial cavity), congestion of the veins, and initial swelling of the optic disc.

With further progression of intracranial hypertension, mental disorders, memory loss, increasing changes in the fundus- pronounced stagnation with prominence of the discs is determined optic nerves V vitreous, hemorrhages, plasmorrhagia and white lesions ( secondary atrophy) on the fundus. Symptoms of advanced intracranial hypertension include the appearance of blurred vision (periodic darkening of vision when the position of the head changes or slight physical exertion).
Decompensation of intracranial hypertension ends with symptoms of progressive disturbances of consciousness(up to coma) and vital disturbances, one of the causes of which are dislocations and herniations of the brain.

Diagnosis of brain tumors.

1. Careful neurological examination , including expanded ophthalmological examination acuity, visual fields and fundus.
2. Of primary importance for identifying a tumor, its topics, and sometimes its histostructure, are modern methods neuroimaging – CT (computed tomography), MRI (magnetic resonance imaging), angiography, etc., and also radioisotope methods and special neurosurgical operations – stereotactic biopsy, ventriculoscopy.
3. Electroencephalography(EEG) is used to identify focal disturbances in the biopotentials of the brain and/or assess the severity of disturbances in brain activity in general.
4. Radiography allows us to identify secondary signs intracranial hypertension and sometimes local changes in the bones of the skull caused by a tumor. Essential diagnostic value does not exist and is rarely used in neuro-oncology.
6. Ultrasonography used in children with open fontanelles. Provides good quality diagnostics, including intrauterine ones. The possibilities of use are limited by the age of the patients (usually up to 1 year).
7. Lumbar puncture. Used to measure pressure and laboratory analysis cerebrospinal fluid, but is currently practically not used for diagnostic purposes in neuro-oncology. It should be remembered that with many tumors and increased intracranial pressure lumbar puncture can cause dislocation and herniation of the brain and therefore, without special indications, it’s better not to do it.

Neurosurgeon – narrow specialist, whose responsibilities include identifying and surgically treating pathologies of the nervous system. The work of this specialist is associated with great risks and responsibility: an untimely response to a particular CNS lesion can have disastrous consequences for the patient. Surgical treatment of such ailments is not always a guarantee. complete cure patients.

Sections of neurosurgery

The discipline in question deals with the study of nervous disorders, in the treatment of which it is mainly used surgical intervention.

Neurosurgery, according to medical qualifications, has several areas:

Neuro-oncology. Specializes in invasive removal malignant neoplasms, which are localized in the head or spinal cord.
Vascular neurosurgery . Deals with surgical treatment of arteriovenous aneurysms; hematomas that formed inside the skull; arteriosinus anastomosis, etc.
Neurotraumatology . In charge of eliminating the consequences of a bruise/fracture of the skull or vertebra.
Psychosurgery . It is a set of operational techniques used to treat mental illnesses. Surgery is performed on the brain, and its consequences are irreversible.
Pediatric neurosurgery . He treats nervous diseases in patients under the age of 18.
Spinal neurosurgery . This branch of neurosurgery is encountered by those who are diagnosed with various types of disorders in the structure and functions of the spinal cord and spine.
Functional neurosurgery . This includes everything surgical procedures, which are aimed at normalizing the functioning of the central nervous system. The main objectives of this branch of neurosurgery are the invasive treatment of hyperkinesis, epilepsy, and chronic pain.

What does a neurosurgeon treat?

In the event that the patient is concerned about disorders associated with the functioning of the central nervous system (back pain, frequent migraines, muscle weakness) - first of all, he needs to contact to the local therapist.

The specified specialist after examination, studying the medical history, taking standard tests will determine - To which doctor should such a patient be referred:

Neurologist. This doctor deals with conservative treatment of pathologies of the nervous system. This name for the medical profession is a relative innovation: at the end of the last century, the same specialist was called neurologist.
Neurosurgeon . Deals with ailments related to the functioning of the nervous system organs that require surgical intervention. The work of this specialist is associated with great responsibility: the patient’s life will depend on the actions and degree of response of the doctor.

A neurosurgeon is engaged in the diagnosis and surgical treatment of many pathologies, the main of which are:

Anomalies in the structure of the brain and skull that are congenital.
Deviations in work spinal column, which are characterized by the presence of neurological syndromes.
Regular pain that developed against the background of errors in the functioning of the peripheral and/or central nervous system.
Fractures of the skull, spine, as well as the consequences of similar injuries: intracranial or spinal hematomas, hemorrhages, etc.
Deformity and dysfunction blood vessels, which are located in the brain/spinal cord.
Meniere's syndrome.
Inflammatory phenomena in the meninges.
Pathologies, the essence of which is insufficient blood supply to the brain, which can only be eliminated through invasive techniques. Examples of such pathological conditions are intracerebral hemorrhages and ischemic strokes.
Malignant and non-malignant neoplasms in the nerve sheaths, pituitary gland, eyes, at the base or in the middle of the skull, inside the spinal column.
Muscle weakness, general loss of strength associated with malfunctions of the vestibular apparatus.
Pathologies of the brain and spinal cord - regardless of the patient’s age.

What symptoms should you contact a neurosurgeon for - all cases

The patient can be examined by the specified doctor on the referral of other specialists in the following cases:

To determine the strength and nature of the skull injury. After examining the patient, diagnostic measures the neurosurgeon makes a decision on the advisability of the operation.
For cancer spinal cord or brain.
In the case of differentiated diagnosis of pathologies , which relate to the functioning of brain components.
In the presence of congenital anomalies associated with organs of the nervous system.

IN emergency assistance A neurosurgeon is needed for patients with gunshot, stab, chopped and other wounds, as a result of which the structures of the nervous system were affected.

Consultation with a neurosurgeon may be required if the following pathological conditions are present:

Frequent migraines.
Sudden fainting, which occurred several times.
Various tics (for example, twitching of the right or left eyelid).
Unreasonable lapses in memory.
Tremor of the limbs and other parts of the body.
Epileptic seizures.
Sudden onset muscle weakness that affects coordination of movements.
Numbness of the toes due to regular pain in the lower limbs. Pain can be localized in various areas: hips, lower back, legs, feet. Such complaints may indicate that the patient has a lumbar hernia.
Regular races blood pressure, which are combined with numbness/pain of the upper extremities, severe dizziness. Such phenomena are a characteristic sign of cervical hernias.
Constant pain in the chest area may be a manifestation of a hernia thoracic. Often people whose body long time is in a forced position. This pathology often occurs against the background of scoliosis.
Nausea and vomiting, spatial disorientation, clouding of consciousness, ringing in the ears and some other conditions that occur after strong blow head. The listed symptoms are grounds for immediate hospitalization.

Studies that a neurosurgeon can prescribe for accurate diagnosis and treatment

The examination by a neurosurgeon begins with a survey, during which this specialist determines the stage of development of the pathology.

A general inspection includes checking the following conditions:

Skin reaction to external irritants.
The nature of the mobility of muscles and joints.
Reflexes.
Oculomotor reactions.

There is a whole range of diagnostic measures that make it possible to study the state of the nervous system organs.

1. Hardware methods:

Application computed tomography to identify various errors in the functioning of the brain: pathological neoplasms, atrophy of the cerebral cortex, accumulation of fluid in brain structures, etc.
. Gives you the opportunity to get detailed information about the state of nerve structures.
Spinal puncture (lumbar puncture) for the purpose of collecting cerebrospinal fluid to study its characteristics: consistency, color, amount of protein and sugar, level of red blood cells and white blood cells. During this diagnostic procedure, you can also determine the level intracranial pressure, identify harmful microorganisms in the cerebrospinal fluid.
Echoencephalography. The main diagnostic tools in this technique are ultrasonic waves. With their help, it is possible to identify the level of displacement of brain structures in case of extensive hematomas or due to the development of hydrocephalus.
Electroencephalography. Neurosurgeons practice this method when diagnosing epilepsy, encephalopathy, and insomnia. Electroencephalography can be used to detect electrical activity brain structures.
Study of the structure and condition of the blood vessels of the brain using X-ray equipment and contrast agents. This method are called cerebral angiography.
Myelography. According to the principle of operation, the method under consideration is similar to the previous procedure, but the object of study here is the spinal cord. Myelography is very indicative in diagnosing intervertebral hernias.
Positron emission tomography. Favors receiving important information in case of epilepsy, stroke, brain cancer.
Electromyography (EMG). Used to study the level, nature, and extent of damage to the neuromuscular system. Using EMG it is possible to identify the exact localization pathological process, as well as the area of its distribution.
Ultrasound and Doppler scanning methods of blood vessels are used when there is suspicion of arterial stenosis, blockage and dissection.

2. Laboratory methods

General blood and urine analysis.
Biochemical study of blood samples. The main components that interest the neurosurgeon will be urea, sodium, potassium, bilirubin, total protein, etc.
Testing blood for its clotting time.
Detection of prothrombin index and/or fibrinogen.

The largest neurosurgical hospital in the world is located in Moscow, and it is called the Burdenko Clinic. Experienced staff, excellent service, the latest equipment did their job - every day in this medical organization the most successful heavy operations on the brain and spinal cord. People from all over the country and even other continents fly here for successful treatment and rehabilitation. Today we will find out where this institution is located, what doctors work in it, and also what the patients themselves think about this organization.

Brief description

The Burdenko Institute or Clinic is an institution that began its activities in 1932. Today this medical institution is the oldest in Russian Federation. At the same time, it is the largest institution in the world that provides assistance to people with problems with the nervous system. The structure of the institute includes the following divisions:

Operating block.

Two neurosurgery departments for children.

Four neuro-oncology units.

Department of problems with the back, brain, spine.

Reanimation unit.

Department with computer and magnetic resonance imaging.

Division of Vascular Neurosurgery.

Where is the institution located?

The address of the Burdenko clinic is as follows:

Moscow, 4th Tverskaya-Yamskaya street.
Moscow, 1st Tverskoy-Yamskaya lane.

Why two addresses, you ask? The institute is located in 2 buildings. The first on the list is a new institution, the second - the scientific diagnostic department - is located in the old building.

Doctors of a medical institution

The Burdenko Clinic is a huge institution that employs 323 doctors. Specialists of this medical institution:

Neurosurgeons;

Neuroresuscitation specialists;

Chemotherapists;

Neurologists;

Microbiologists;

Neuroanesthesiologists;

Anesthesiologists-resuscitators;

Neuroradiologists;

Neuroophthalmologists;

Endocrinologists;

Pharmacists;

Pediatricians;

Neuropsychology;

Therapists;

Radiologists;

Physiotherapists;

Psychiatrists;

Neuropathomorphologists;

Otoneurologists;

Urologists;

Oncologists;

Otolaryngologists.

What services are provided?

The Burdenko Clinic in Moscow accepts Russians and helps them:

Identify neurosurgical diseases.

Prepare for surgery.

Get rid of the disease through surgery or medication.

To endure the postoperative period mentally and physically.

By the way, this medical institution provides diagnostic services for residents of other countries.

To get to this clinic, you need to have your passport with you.

What diseases are treated at the facility?

Providing qualified medical care people with diseases of the spinal cord and brain - main task Burdenko Institute. Neurosurgery is the main activity of the institution. This clinic helps get rid of tumors of the brain, skull, spinal cord, and peripheral nerves. Meningiomas, neuromas, neuromas, cysts - the doctors of the institution encounter all these problems every day, and they successfully perform operations so that a person can begin to live fully again.

Paid or free services?

The Institute of Neurosurgery named after Academician N. N. Burdenko accepts both residents of Moscow and other Russian cities, as well as foreign citizens. The only question is who has the right to receive free help, and who will have to shell out a certain amount for examinations and consultations.

Only citizens of Russia can get an appointment with a doctor on a budgetary basis, and only if they provide the following package of documents:

A referral from a city Moscow clinic at the place of registration (registration) or a referral from the Ministry of Health of another region of the country.

Written opinion from an ophthalmologist and neurologist.

MRI and/or CT scan done within a month before going to the clinic.

Health insurance policy.

If the patient does not have at least one document from the list above, he will have to be examined for on a paid basis.

Paid services: cost

They are provided:

Foreign citizens.

Russians who have not collected a complete set of documents to receive free help in an institution such as the Burdenko Clinic.

Prices for some services are presented below:

Initial consultation - from 2 to 8 thousand rubles, depending on which doctor conducts it (academician, professor, doctor of sciences).

Without contrast - 5 thousand rubles, with contrast - 7 thousand rubles.

MRI of the brain - 6 thousand rubles.

MRI of the brain and spine with contrast - 26 thousand rubles.

X-ray - from 800 rub. up to 3500 rub. depending on the organ being examined.

Ultrasound - from 1100 to 3500 rubles. depending on the location of the examination.

Taking primary tests for neurosurgical operation- 8400 rub.

Physical therapy - from 1 to 2 thousand rubles. depending on the severity of the patient.

Massage - from 1200 rub. for 1 session.

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Clinic

This institute block provides consultations for people with neurological and neurosurgical diseases. In addition to considering the patient’s complaints, doctors here can additionally conduct studies such as computed tomography, MRI, ECG, etc. It is within the walls of the clinic, based on the results of examinations, that doctors decide to perform an operation. Reception here is carried out from Monday to Friday from 9 am to 3 pm. Moreover, depending on the diagnosis, a specific appointment day is assigned. So, Monday is the day for receiving patients with brain tumors. On Tuesday, specialists are ready to receive patients with diseases of the pituitary gland and chiasmatic region. On Wednesday, as planned, consultations on traumatic brain injuries are being held at the Burdenko Clinic. Neurosurgery, spinal pathology, spinal tumors - all these problems are also discussed on this day. On Thursday, patients are consulted about pathologies in children. And on Fridays people come with vascular problems central nervous system.

Vertebrology department

Spinal neurosurgery at the clinic named after. N. N. Burdenko is a priority direction of the institute. The specialists of this department accept inpatient treatment patients with neurosurgical diseases:

Spine, peripheral nerves.

Degenerative disc lesions, stenoses spinal canal, spondylolisthesis, etc.).

Congenital anomalies of the spine.

Consequences of injuries to the spine and nerve plexuses.

Vascular department

Vascular neurosurgery is another important area of activity of the Burdenko Clinic. This department employs professionals with extensive experience in therapy. various diseases vessels of the central nervous system: cavernous angiomas, malformations, hemorrhagic stroke etc. Every year, surgeons perform over 500 operations. New methods of treatment have already been introduced in this department. vascular diseases high degree gravity.

Pediatric department

Pediatric neurosurgery is another area in which the clinic’s specialists work. The main goal and work of this department is the treatment of brain and spinal cord tumors in boys and girls. The clinic performs operations to remove benign and malignant tumors. The institution’s specialists are also developing new methods of surgical intervention for congenital defects development of the central nervous system. Since the department accepts young patients whose psyche is not yet fully formed, other doctors, in addition to neurosurgeons, are involved in the therapy: pediatricians, oncologists, psychologists, neurologists, endocrinologists, radiologists, etc.

Department of Functional Neurosurgery

The task of this medical unit of the institute is to successfully correct disorders of muscle tone, tremor, muscular dystonia, children's cerebral palsy), spastic syndromes, neuralgia of the cranial nerves and other ailments. This department widely uses the method of stimulating deep brain structures.

Operating block

He is the “heart” of the clinic. The operating block is represented by 14 rooms, of which 3 are specialized X-ray rooms, 1 is emergency. Every day the institute performs up to 30 operations. Each room has an air conditioning and ventilation system. This ensures a high level of comfort and sterility. Operating rooms have autonomous system energy supply. Why are surgeries successfully performed at the Burdenko Clinic? Of course, the human factor counts. But even this cannot always help in severe cases. The latest modern equipment: special microscopes, instruments, high-speed burs, lasers help to perform surgery on the highest level. In addition to serious and dangerous surgical interventions, this institute also performs minimally invasive operations - intravascular, endoscopic, etc.

Types of therapy

The Burdenko Clinic in Moscow uses 4 types of treatment:

A simple observation.
Radiation therapy.
Neurosurgical operation.
Chemotherapy.

What type of treatment to choose is decided at a consultation of doctors.

Positive evaluations from people

The Burdenko Clinic receives different reviews from patients who have been there. Those people who liked this institute note the following: positive points in it:

A team of professionals. Many patients note that the doctors in this clinic are from God. In addition to their professionalism, thanks to which they save the lives of many people, doctors are also kind and generous by nature.

Service. Patients note that when you are hospitalized at this medical institution, you never think that you will sleep on orthopedic beds, in wards with good repair. Each room has a button to urgently call a doctor. It is comfortable and safe for people to walk along the corridors, since special handrails are installed there so that patients can hold on to them. Large windows from the ceiling to the floor let in a lot of light, so the hospital does not seem dull and gray. Many people note that this clinic feels like home.

Free assistance. Of course, not everyone is lucky enough to get it, but there are still many such people. But the best part is that even if you don’t pay money, no one will demand it from you. The nurses and doctors of this institution will never even mention a bribe or financial gratitude.

Negative ratings from people

The Burdenko Clinic does not always receive positive feedback. There are also a certain amount people who did not like being treated in this medical institution. Patients discuss their dissatisfaction with the work of the staff and, in general, with the entire organization on many forums. Here's what negative points people note:

Absence free seats. Clinic named after Burdenko - famous institution, to which people are sent from all regions of Russia. Since the country is large, there are many sick people. Despite the fact that the clinic occupies a large area, it accommodates huge amount people, but there is not enough space for everyone. Many people have to wait in line for surgery for 2 weeks or a month.

Expensive. Patients note that it is unrealistic for an ordinary Russian to be treated in this clinic without a quota for free care. Cost of consultation, various diagnostic procedures, the cost of the operation itself is so high that not everyone can afford to be treated in this organization. And getting permission to get free help can be very difficult.

Speed of discharge after surgery. Some patients write on forums that people who underwent surgery in this clinic are discharged almost on the second day. They say there are not enough places in the wards; hundreds of patients come to the institute every day. In order to help all patients as much as possible, the administration of the institution tries to discharge as early as possible those patients who have already been operated on and the operation was successful. It even happened that a person was discharged already 4 days after the most complex operation on the skull. At the same time, the patient could not get up on his own, but all the documents for discharge had already been prepared for him.

It is not doctors and professors who operate, but young graduate students. It is this fact that many patients do not like. People have to trust young students. Even though some professor sits in a special room and monitors the actions of his subordinates, it would still be better if he operated. This is exactly what many patients think. Maybe then there were no cases of unsuccessful operations, after which people either remained crippled or were sent to the morgue?

Conclusion

The Burdenko Clinic is a medical institution on which millions of Russians, as well as citizens of neighboring countries, place their hopes. After all, this is where real professionals work - neurologists, neurosurgeons of the country. These doctors perform operations on the human brain and spinal cord every day, returning people to normal full life. This establishment receives both positive and negative reviews people. But if he had not been in the vastness of Russia, then people would have been left to deal with their troubles on their own. Burdenko Clinic is real God's temple, in which consultations and operations are carried out free of charge, as well as on a paid basis.