Neurologist vs Neurosurgeon – The brain specialists

Neurologist vs Neurosurgeon. The basic answer would be a neurosurgeon operates on the brain while a neurologist doesn’t, but it is far more complex than that.

Role of Neurologist

A neurologist specializes in the medical diseases of the peripheral and the central nervous system and their cures. The peripheral nervous system (PNS) includes the nerves and the ganglia in the human body. Similarly the central nervous system (CNS) includes the brain and spinal cord. The medical aspects includes illnesses, conditions and syndromes that affect the human nervous system. Examples of diseases affecting the PNS include conditions like:

  • Brachial Plexus Injuries.
  • Myasthenia Gravis (MS).
  • Carpal Tunnel Syndrome.
  • Complex Regional Pain Syndrome.
  • Degenerative Nerve Diseases.
  • Diabetic Nerve Problems.
  • Guillain-Barre Syndrome.
  • Pain.
  • Sciatica etc.

Diseases that affect the central nervous system include

  • Alzheimer’s Disease.
  • Amyotrophic Lateral Sclerosis (ALS)
  • Ataxia.
  • Bell’s Palsy.
  • Epilepsy and Seizures etc.

As most ailments of the nervous system are highly complex, it is very common that a multi-disciplinary team is formed in hospitals. These teams consist of both neurologists and neuro surgeons and are there to take care of the patients. As neuro patients are one of the most sick patients in any hospitals, the teamwork approach enables to get the patients to recovery quickly and promptly.

Neurologists are brain geeks. Most of their day to day activities involve performing extensive examinations to judge the various nerves in the human body and to assess their functioning. They carry out brain wave studies called electroencephalography (EEG) and sleep studies. All procedures are designed to study the brain and figure out the patterns in the brain functionality that are causing the disease. It is not uncommon among neurologists to argue half an hour to 45 minutes about the prescription of one patient, and then later deciding to not change it entirely.

Neurologists also treat CNS and PNS tumors that are treatable medically or via chemo. They would mostly be on the oncology department’s team to prescribe chemotherapy to the patients. Neuro-oncology is a very vast field and most neurologists usually receive training in this field.

Topic: Neurologist vs Neurosurgeon | Left Neurology, Right Neurosurgery (Images courtesy of medical news today)

Role of Neuro Surgeon

A neuro surgeon doctor more commonly referred to as a brain surgeon, is a surgeon of the brain. A neuro surgeon specializes in putting patients under the knife and performing operations on the brain, spinal cord, peripheral nerves and ganglia. He specializes in:

  • Trauma care of patients with head injuries.
  • Trauma care of patients with spinal injuries
  • Surgical excision of tumors.
  • Functional problems in brain circuits.
  • Brain aneurysms
  • Nerve transections
  • Nerve compression disorders e.g. radiculopathy

The typical cases that a neurosurgeon will mostly receive on a day to day basis include:

  • Epidural Hematoma.
  • Spinal Cord Injury.
  • Basilar Skull Fracture.
  • Concussion.
  • Intraparenchymal Hemorrhage.
  • Skull Fracture.
  • Spinal Fracture.
  • Traumatic Nerve Injury.
  • Cervical Spine Fractures.
  • CSF Rhinorrhea etc. Find more here.

The field is drenched with very hard to perform procedures mostly involving opening up the cranium. So it is not for the faint of heart. The patients in neurosurgery are very ill and its always a do or die situation on the wards. As a neurosurgeon most of your day will be spent in the operating room, performing very long and taxing procedures. Or you may be in the neurosurgical ICU checking on the prognosis of prior patients. And you will most definitely be called to the ER at least once an hour to clear patients who have undergone head trauma. Neuro surgery is taxing, that is probably why it is the most prestigious and the most well paid specialty in all of healthcare.

Neurosurgeons also deal with the excision of tumors of both the brain and the spinal cord. When a tumor is found, it is treated either via medical therapy or chemotherapy, which come under the domain of neurologists and oncologists or surgery. For surgery on the neural structures a neurosurgeon must be asked. Neuro teams will mostly contain one to three neurosurgeons to deal with the surgical aspects in neuro-oncology.

Neurosurgeons also are licensed to operate on the spine similar to orthopedic spine surgeons. But while the later focus more on the fractures of the spine and bony pathologies, neurosurgeons will deal with the spinal cord itself.


So, I think this article will clear all your misconceptions about either of the roles. Both are very important specialties in healthcare and both have their own unique procedures, cases and care.

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