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Nevrokirurgi

Gammelt tysk trykk som viser et instrument til å tvinge på plass innslåtte stykker av skallen.
Edwin Smith papyrusen fra cirka år 3500 fvt. omtaler åpne skalleskader.

Nevrokirurgi er en kirurgisk disiplin innen nevrologien som befatter seg med behandling av lidelser i sentralnervesystemet og det perifere nervesystem, samt omkringliggende strukturer. En lege med spesialisering i nevrokirurgi kalles en nevrokirurg. En gren av nevrokirurgien kalles hjernekirurgi, og en hjernekirurg er en nevrokirurg med spesialisering i kirurgi i hjernen.

Nevrokirurgi er en svært gammel disiplin. Det er kjent at mennesker i flere kulturer har utøvet hjernekirurgi flere tusen år før vår tidsregning. Edwin Smith papyrusen fra cirka år 1600 fvt.[1] omtaler 48 tilfeller av skader, brudd, sår, dislokasjoner og svulster.[2] Blant pionerene i nyere nevrokirurgi regnes Victor Horsley (1857–1916) i England, William Macewen (1848–1924) i Skottland og Fedor Krause (1857–1937) i Tyskland. Den første norske nevrokirurgen var Vilhelm Magnus (1871–1929). Den moderne nevrokirurgiens fedre regnes imidlertid for å være den amerikanske nevrokirurgen Harvey Williams Cushing (1869–1939)[3] og, spesielt, den tyrkiske nevrokirurgen Gazi Yaşargil (1925–)[4].

Nevrokirurgi regnes som en egen displien innen nevrologien i det fleste land i verden. Spesialisering i nevrokirurgi tar minimum seks og et halvt år. Legespesialiseringen kan først begynne etter at man er ferdig med medisinstudiet og har fått autorisasjon som lege. Den første delen er felles for alle spesialitetene og varer i halvannet år. Den består av ett års praksis på et sykehus og et halvt års praksis i en kommune (også kalt LIS 1). De neste fem årene er spesialisering innen den retningen man velger. Mange nevrokirurger er dessuten involvert i forskning og innehar ytterligere spesialisering med en tilhørende medisinsk doktorgrad (Ph.D. eller dr.med.).

Fagfeltet inkluderer forebygging, diagnostisering, behandling og rehabilitering av sykdommer som affiserer sentralnervesystemet og perifere nerver. Tilstander som behandles av nevrokirurger er for eksempel hjernesvulster, hjerneblødninger, hodeskader, hydrocephalus, rygg- og nakkelidelser, kroniske smertesyndromer og bevegelsesforstyrrelser (som for eksempel Parkinsons sykdom). Faget stiller store krav til fagkunnskaper, beslutningsdyktighet, stressmestring og operasjonsferdigheter. I Norge utøves nevrokirurgi ved Oslo universitetssykehus (både Rikshospitalet og Ullevål sykehus), Haukeland universitetssykehus i Bergen, St. Olavs hospital i Trondheim og Universitetssykehuset i Nord-Norge i Tromsø, samt i et mindre omfang ved Stavanger universitetssjukehus.

Se også

Referanser

  1. ^ Allen, J. P. (2005). The art of medicine in ancient Egypt. Metropolitan Museum of Art. ISBN 978-0-300-10728-9
  2. ^ Lawrence, Christopher (2008). Surgery. In Lerner, K.Lee; Lerner, Brenda Wilmoth (eds.). Biomedicine And Health: Surgery. In Context. Vol. 1. Detroit: Gale. ISBN 978-1-4144-0299-4.
  3. ^ Bhattacharyya, K. B. (2016). Harvey William Cushing: the father of modern neurosurgery (1869–1939). Neurology India, 64(6), 1125. https://www.neurologyindia.com/text.asp?2016/64/6/1125/193810
  4. ^ Lovato, R. M., Vitorino Araujo, J. L., de Paula Guirado, V. M., & Veiga, J. C. (2016). The Legacy of Yasargil: the Father of Modern Neurosurgery. The Indian journal of surgery, 78(1), 77–78. https://doi.org/10.1007/s12262-015-1421-6

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