Interventional Neuro or Neurosurg?

[DocK]

If interventional neurology is a total approximate 7yrs PG training; why not just do neurosurgery? Is there really a large difference in terms of lifestyle?

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[Nerdoscience]

Just because they are both neurological and just because they are both interventional does not mean these specialties are that similar. The training is totally different in terms of material and in terms of work hours and lifestyle. Beyond that, lifestyle is something that is highly variable depending much on what responsibilities you choose to take.

It's analogous to saying that it takes the same amount of time to make a chicken pot pie and a strawberry rhubarb pie, so why not just eat chicken for dessert? Don't you eat both of them with a fork? Sounds ridiculous, huh?

 

[bustbones26]

If interventional neurology is a total approximate 7yrs PG training; why not just do neurosurgery? Is there really a large difference in terms of lifestyle?

Even a neurosurgeon who has an interest in endovascular procedures has to seek some type of extra training outside of his/her residency, hence, fellowship.

 

[DocK]

Perhaps you could expound more on the differences in lifestyle and germane treatable illness specific to each field; you know, might me more useful than, say, throwing out analogies to cooking. Just my 2 cents...

 

[Nerdoscience]

It's such a big topic, I don't know where to begin, so here are some random things. Neurosurgeons can do tons of non-emergent spine surgeries in the morning 4 days a week, go golfing every afternoon, rake in huges amounts of dough, and never have to be on call if they want to. They could ALSO do delicate brain procedures, be on call in the hospital overnight several times a week, and have no idea what season it is, it's been so long since they've been outside, and make only lots and lots of money, not nearly as much as the other guy. It all depends on where you work, if it's academic or private, whether you choose to one thing or another, etc...

Neurointerventionalists as a rule of thumb tend to be in academic settings and have lots of overnight call, which sucks. I know of some who are esentially on call to come to the hospital 24/7 if there is a stroke patient.

Some neurointerventionalists also treat general Neuro stuff outpatient or inpatient. Many also to neuro-critical care.

Not that Neuro residents have it easy; I'm a Neuro resident, and I would not call my schedule easy, but it does not even compare with the average Neurosurg residency, which is longer and ridiculously demanding time and energy wise.

I guess that's a start. Hopefully, someone else will have more to say.

 

[hans19]

Perhaps you could expound more on the differences in lifestyle and germane treatable illness specific to each field; you know, might me more useful than, say, throwing out analogies to cooking. Just my 2 cents...

If you are curious or truly interested in those fields, how about googling it first before making broad assumptions? Just my 2 cents...

 

[Happy613]

I think they are two very different fields. While there is a large degree of overlap, at NJMS (where I go to school) the interventional neurologists do all the stroke cases. That is all the interventional angio procedures (IA tpa, stenting, balloons, clot retrieval, etc...) and all of the neuro icu managment of those patients. The endovascular neurosurgeons usually do the emergent sah's or aneuruysms. However they do cover for each other and all of the neuro-angio doctors are trained in all of the procedures.

There are two points to keep in mind, firstly interventional neurology is a rapidly exapanding field, and many more outpatients procedures are being developed. I beleive that this will afford people in the field a certian amount of freedom in choosing thier lifestyle.

The second point, is that if you are like me and think that interventional stroke is just the coolest thing in the world than neurology is the way to go. There are very few things in the world of medicine that are as powerful as stopping a stroke. I think if stroke is what really interests you than this is the field for you.

 

[cooldreams]

so if i wanted to do work invovling new technologies that allowed communication to and from the brain with a computer or similar electronic device, what specialty should i go into???

im thinking neurology because they focus on the actual functioning of the nervous system.

but they dont actually do anything to the body physically do they?? or do they perform any "minimally invasive" procedures??

so with that im thinking maybe neurosurgery??? there would likely be some surgical procedures involved, however these would really be minimal, just to allow an electrical connection to a periphial or central nerve for communications in something.

or is this what interventional neurology would do??

 

[hans19]

so if i wanted to do work invovling new technologies that allowed communication to and from the brain with a computer or similar electronic device, what specialty should i go into???

im thinking neurology because they focus on the actual functioning of the nervous system.

but they dont actually do anything to the body physically do they?? or do they perform any "minimally invasive" procedures??

so with that im thinking maybe neurosurgery??? there would likely be some surgical procedures involved, however these would really be minimal, just to allow an electrical connection to a periphial or central nerve for communications in something.

or is this what interventional neurology would do??

In terms of implantable devices interacting with the CNS, neurosurgeons currently place deep brain stimulators for the treatment of some movement disorders. Some interventional pain specialists (anesthesiologists by background) implant spinal cord stimulators for spasticity or pelvic pain.

I think your best bet would be neurosurgery as they are the only ones that do open brain procedures. Neurologists for the most part don't do many invasive procedures, except for perhaps an EVD in the neuro ICU. Even then its only at select institutions.

 

[Spacedman]

so if i wanted to do work invovling new technologies that allowed communication to and from the brain with a computer or similar electronic device, what specialty should i go into???

im thinking neurology because they focus on the actual functioning of the nervous system.

but they dont actually do anything to the body physically do they?? or do they perform any "minimally invasive" procedures??

so with that im thinking maybe neurosurgery??? there would likely be some surgical procedures involved, however these would really be minimal, just to allow an electrical connection to a periphial or central nerve for communications in something.

or is this what interventional neurology would do??

hi cooldreams, i'm also very interested in neural prostheses and have been going through a similarly tough time deciding on a specialty. i tried to talk to as many people as i could at this most recent neuroscience convention (SFN in atlanta).

One example: UCSF/berkely has a very active neurosurgical research program which involves implanting electrodes for electrocorticography & DBS- do a pubmed on MS Berger, NM Barbaro or TR Knight. Their students told me that Berger or Barbaro open the case and actually place electrodes (the nsg involved depends on whether the pt is in for a tumor or epilepsy). From that point, the neurologist's team (most of whom are PhDs, not MDs) actually do the recording/stimulating/testing/whatever.

Another example: for DBS, which right now is only FDA approved for dyskinesia & parkinson's but may eventually find use for OCD, migraines, depression etc, is performed by functional/stereotactic neurosurgeons. While this sounded very cool to me, placement (again) is pretty routine. Its mostly basic scientists/some neurologists that determine the location & protocol for stimulation.

Finally, you should be aware of a rather groundbreaking study of in vivo cortical plasticity using a prosthetic device (nature, oct 06):

http://www.ncbi.nlm.nih.gov/entrez/..._uids=17057705&query_hl=5&itool=pubmed_docsum

note, none of these authors are MDs- they all appear to be from engineering, physiology & biophysics departments. A couple other figures in this field that are well worth checking out: John Donoghue & Miguel Nicolelis, i don't think either of them have MDs.

If you really want to do this type of research from the electrical engineering side, I would take a long look at whether its worth 8+ years of MD + residency. If you want to do medicine, it seems to me neurology is the best fit. INR do most ly emergent stroke, and there are about 5 NSGs in the US that can both run a lab of some quality and still retain their operating skills (forget about seeing your family).

hope this helps
s