• neurosurgery

When Thomas Willis (1621–1675) first used the term “ neurology” in Cerebri Anatome to mean knowledge of the cranial, spinal, and autonomic nerves, he did not specify whether practitioners should be physicians or surgeons. The physicians won the mantle but somehow this did not catch the imagination of the public or even aspiring doctors¹ in the same way as that of being a “brain surgeon”, a term proverbially ranked alongside “rocket scientist”, indicating the very acme of medical achievement.

With more modesty the Society of British Neurological Surgeons (SBNS) defines the specialty of neurosurgery as that of “the clinical management of patients with potentially surgical remediable conditions of the central (intracranial and spinal) and peripheral nervous system”. In their important document Safe neurosurgery 2000, they recommend that neurosurgical units should be situated within a multidisciplinary neuroscience centre on a general hospital site, and should provide both core and subspecialty services.² While neurosurgery is thus commonly sited alongside neurology, the reverse is not always true. An increasing number of UK neurologists, while regularly attending a neuroscience centre, spend the majority of the working week away from their surgical colleagues. Neurologists thus need to be informed and equipped to work without immediate access to a neurosurgeon.

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