Neurosurgery has evolved over the past century from a rare activity carried out by general surgeons caring for patients with head and spinal trauma to an important clinical entity. Early operations that involved the central nervous system were performed by general surgeons with considerable help from neurologists. At that time, the surgeons were the technicians and the neurologists told them what to do.
Neurosurgery has evolved over the past century from a rare activity carried out by general surgeons caring for patients with head and spinal trauma to an important clinical entity. Early operations that involved the central nervous system were performed by general surgeons with considerable help from neurologists. At that time, the surgeons were the technicians and the neurologists told them what to do.
The neurosurgical techniques introduced and knowledge gained by the pioneers of the early 20th century were widely disseminated, and the improvements in anaesthesia, blood transfusions and diagnostic imaging, as well as the institution of training programmes, all led to the advancement and consolidation of the speciality.
Recent developments in diagnostic technology, therapeutic technology – both surgical and non-surgical – and interface technology have had a major impact on neurosurgical practice: neurosurgery, like other surgical specialities, is becoming increasingly subspecialised. The need for further training in a specific neurosurgical field has multiple implications, both practical and legal. Should a neurosurgeon in one of the subspecialties perform procedures and provide care for patients exceeding the strict limits of his or her subspecialisation? Does a general neurosurgeon have the right to perform complex vascular or paediatric procedures? If the practice of every neurosurgeon is restricted to the subspecialisation, will there be a sufficient number of practitioners to meet the emerging neurosurgical requirements of communities?
The present curriculum for neurosurgical training in Europe is not uniform. The recent political and financial unification of Europe has demanded the establishment of a common European neurosurgical training programme that guarantees a similar level of education among neurosurgeons from the different European countries. Fortunately, the creation of the European examination system for the accreditation of neurosurgeons by the European Association of Neurosurgical Societies (EANS) represents a major breakthrough in this direction.
The exchange and communication of scientific achievements among the European neurosurgical schools are prerequisites for the development of neurosurgery. This issue of European Neurological Disease facilitates this process, showcasing achievements not only in neurosurgery, but also across the entire neurology spectrum. ■
