Differance between Neurology and Neurosurgery

[Leukocyte]

It seems to me that Neurosurgeons know a lot about Neurology. So what is the real difference between a Neurologist and a Neurosurgeon ? What extra knowlegde do neurologists have over neurosurgeons ? What makes Neurology unique ?

Thank you.

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[bustbones26]

Ok this is a no brainer (no pun intended)

Neurosurgeons are surgeons, they cut. They have to do a general surgery internship before starting into a PGY-2 neurosurgery program. Most agree that the bread and butter of a neurosurgeon is spine surgery: fusions, laminectomies, discetomies, etc.

Neurologist perform an internal medicine internship first and mostly perform medical managment of neurological diseases: MS, parkinsons, migraines, etc. Most neurology patients follow up with the neurolgist in the outpatient setting and discuss how their disease is doing, is it better or worse with the current drugs, are they having any bad side effects from their current medical therapy etc. etc. The neurologist gets consulted to the hospital floor by PCP's as well.

Neurosurgeons have to have a broad knowledge of neuroanatomy and neuropathology and have to perform neurological exams just as well as neurologist in order to make a diagnosis and to determine if the patient needs surgery. However, neurosurgeons do not follow and treat patients in their office for neurological diseases: MS, parkinsons, etc.

 

[doc05]

neurologists: generally very smart, know a ton, yet despite all the newfangled drugs, can't really do anything other than prescribe TPA and order MRIs.

neurosurgeons: very smart, know lots of neuroanatomy, operate on brains and spines. brain cases often have poor outcomes: the patients live but are vegetable-like afterwards. the spine cases are incredibly tedious.

 

[bustbones26]

ON a comical note, neurologist have plenty of time and access to the restroom facilities. Neurosurgeons have to have a bladder made of steel or put in their own caths.

 

[cooldreams]

ok, so im coming from kyusho-jitsu. surely someone here has heard of this martial art that uses pressure points. im level 5 in it, and have knocked out ppl with minor attacks to specific points. the neuroanatomy REALLLLLLLY interests me. im only an ms1, but i cant get enough of the neuro ive seen already. so.

my question is, which do you think would mesh better with this interest. i really like the neuroanatomy, but:

neurology: i worry about not really having much physical patient contact. i wouldnt do much physically to help anyone right?? its mostly all drugs. conversely i like having some amount of time to do personal hobbies/family/etc. i also like that while much of the cases would be cronic, they would not be left in a veg state or worse after i finished with them. i also like the academic feeling to it more so. i like to think on things a lot, thorough understanding, make exacting decisions. i think neurology has an interesting future potential as more and more is learned about the neurvous system, though im not completely sure where that future would lie.

neurosurgeon: i worry that even this, most of the work is on the cns, specifically the spine, which at this point would not have much to do with with kyusho as i know it which involves mostly the pns. i do like actually getting in there to work with nerves though, this is afterall the most incredible part of the human body. i see a very interesting future with the meshing of computer technological implants (im an electrical engineer from undergrad). i am somewhat hesitant about the intense work schedule involved, but it worries me to say that that would be enough to keep me out of an otherwise truely amazing field that has so many other pluses.

what do you guys think?? how did you decide??

 

[Bonobo]

It always interests me that there are so many people who are trying to decide between these two fields despite them being SO different.

It really comes down to this. Do you want to be an expert in doing a variety of surgical procedures or an expert on the diagnosis and management of a variety of neurological illnesses? A lot of people claim that neurosurgery is more acute and that neurology involves chronic care. This is not true. Neurosurgeons now spend 85% of their time, like every other field except trauma and transplant (and made-for-TV ER), dealing with chronic back pain and the like. Neurologists still spend much of their time dealing with acute stroke, meningitis, and acute delirium, not to mention NICU/INR as an up and coming player.

A neurosurgeon put it to me simply: do you want to be a surgeon? If I couldn't do anything neuroscience related, would I want to be an internist or a surgeon? This is how the rest of the world puts it to their medical students requiring them to complete internal medicine or general surgery before they can enter either neurology or neurosurgery.

Also, there is a major perk associated with each field. if you want a lot of money and prestige, neurosurgery makes more sense. If you want to spend more of your time doing research and have flexible time off for family and friends, then neurology has always contributed a lot more than neurosurgery.

In the past, there was no in-between field in the clinical neurosciences, as there is in GI, pulmonology and cardiology. Indeed, such in-between fields are the most competitive in medicine b/c they resolve this age-old struggle between the desire to be a bad-ass surgeon and a quixotic physician. Maybe the birth of interventional neurology and neurointensive care is about to change that, so you will probably have more options in the future no matter which direction you take in the end.

B

 

[neurologist]

So what is the real difference between a Neurologist and a Neurosurgeon ?
Thank you.

Mmmmmmmmm, about $500,000 a year.

 

[neurolome]

I agree. But looking at the one harried Neurosurgeon at my institution, I wouldn't trade for all the money in the world. And who in their right mind wants to stand for 23 hours? Jeebus.

 

[hans19]

ok, so im coming from kyusho-jitsu. surely someone here has heard of this martial art that uses pressure points. im level 5 in it, and have knocked out ppl with minor attacks to specific points. the neuroanatomy REALLLLLLLY interests me. im only an ms1, but i cant get enough of the neuro ive seen already. so.

my question is, which do you think would mesh better with this interest. i really like the neuroanatomy, but:

what do you guys think?? how did you decide??

You wanna 'knock out' people?
Go with neurosurg. Even their 'successes' can leave patients with severe neurologic deficits.

You like neuroanatomy? Wanna make 'decent' pay and without working 24/7?
I got one word for you kid--

neuroradiology

 

[fedor]

So what is the real difference between a Neurologist and a Neurosurgeon ?

About 40 points on Step 1.

 

[tylrc]

ok, so im coming from kyusho-jitsu. surely someone here has heard of this martial art that uses pressure points. im level 5 in it, and have knocked out ppl with minor attacks to specific points. the neuroanatomy REALLLLLLLY interests me. im only an ms1, but i cant get enough of the neuro ive seen already. so.

my question is, which do you think would mesh better with this interest. i really like the neuroanatomy, but:

neurology: i worry about not really having much physical patient contact. i wouldnt do much physically to help anyone right?? its mostly all drugs. conversely i like having some amount of time to do personal hobbies/family/etc. i also like that while much of the cases would be cronic, they would not be left in a veg state or worse after i finished with them. i also like the academic feeling to it more so. i like to think on things a lot, thorough understanding, make exacting decisions. i think neurology has an interesting future potential as more and more is learned about the neurvous system, though im not completely sure where that future would lie.

neurosurgeon: i worry that even this, most of the work is on the cns, specifically the spine, which at this point would not have much to do with with kyusho as i know it which involves mostly the pns. i do like actually getting in there to work with nerves though, this is afterall the most incredible part of the human body. i see a very interesting future with the meshing of computer technological implants (im an electrical engineer from undergrad). i am somewhat hesitant about the intense work schedule involved, but it worries me to say that that would be enough to keep me out of an otherwise truely amazing field that has so many other pluses.

what do you guys think?? how did you decide??

if you like knocking people out so much you should go into anesthesia

 

[modisrules]

Hey all -1st time poster,

I did research as undergrad/postbacc in neurology and neurosurgery, and I have to tell you that it really comes down to 2 things:
-Do you wanna be a surgeon or a clinician?
-Can you get into and finish a neurosurg residency?
Of course, these questions imply lifestyle issues, field interests, financial considerations (though both make fine $$$, and if you want to do neurosurg just for the extra bucks you must be insane), but that's really where it's at.

The best neurosurgeons have a good concept of clinical neurology. They understand what is happening clinically and how to approach the clinical case from a surgical perspective. Yes, usually their cases are referred by neurologists, but the better neurosurgeon will also consider the clinical presentation instead of just cutting.

That said, the best clinical neurologists have a good concept of neurosurgery. This is becoming extremely important, given the recent and promising future advancements in neurosurgical interventions. Knowing and believing in the surgical options is already extremely important and will only increase in importance in the future.

My research was in movement disorders, working with teams that specialized in both clinical and surgical management. In particular, deep brain stimulation has done incredible things for movement disorders (approved for PD and ET, HDE for generalized dystonia), and is expanding approaches for other medically intractable neuro/psych disorders. On the teams with which I have worked (Emory, Mt. Sinai NYC, Mass General, U Florida Shands - 4 of the best in the country), all the surgeons were involved clinically and the clinicians were involved surgically. They all the clinical and surgical options and procedures backwards and forwards. I remember one time the surgeon attended neuro clinic and saw patients there as a clinician would - it was during fellowship, but all the neurologists were asking him "Are you sure you're a surgeon?" The neurologists are always in the OR for DBS, some even do the physiologic procedures, which is more surgical than clinical if you ask me. Also, the neurologists managed the DBS postoperatively and need to know the procedure well to be good programmers and troubleshooters.

So neurosurgeons have plenty of clinical patient contact and can maintain great longitudinal patient relationships. Neurologists can do tons of hands-on stuff in the clinic (EMG, EEG, injections, etc) as well as in the OR (physiologic monitoring and mapping, behav/cognitive/psych monitoring).

BTW - if you want to know more about DBS, check out www.offcentertv.com. My school (RWJMS) will be screening Mr. Farkas's full movie later this semester (with panel discussion following), so if you're in the NJ area feel free to come by.