Neurotraumatologist

A neurotraumatologist is a specialist who treats patients with acute injuries to the brain and spinal cord, nervous system, and also eliminates the consequences of such injuries (hematomas, bruises, brain abscesses, poorly located bone fragments, skull deformations, etc.). In addition to injuries, the doctor treats intervertebral hernias, brain tumors, etc.

In addition to treatment, the specialist prescribes and monitors rehabilitation measures after various injuries.

[ 1 ], [ 2 ], [ 3 ]

Who is a neurotraumatologist?

A neurotraumatologist is a doctor whose help is required in cases of craniocerebral trauma, spinal cord injuries, and spinal cord damage. The specialist also deals with the consequences of these injuries (hematomas, deformations, abscesses, etc.).

Neurotraumatology was originally part of neurosurgery. But now it has become a separate science and solves issues regarding traumatic injuries of the nervous system.

When should you see a neurotraumatologist?

A neurotraumatologist may be needed for injuries related to the spine. When injured, a person feels very strong pain, mobility is sharply limited and the person is forced to take an unnatural position. Any attempts to move or take a different position lead to increased pain. When examining the site of injury, swelling or hemorrhage may be seen.

Spinal cord injuries cause severe pain in the neck, back, and head. There may be numbness or tingling in the limbs, a person may completely or partially lose control over some part of the body, difficulty coordinating movements, walking, difficulty breathing, and pressure in the chest area. Swelling may appear in the head or neck area.

People seek help from a neurotraumatologist after falls, bruises, various injuries to the skull and spine. Also, if neoplasms are detected in the spinal cord or brain (or other pathological processes), the patient is sent for examination to a neurotraumatologist.

What diagnostic methods does a neurotraumatologist use?

After the initial examination, a neurotraumatologist usually refers you for a general blood and urine test, which is, in principle, a standard procedure when visiting doctors of any specialization.

Also, if necessary, a specialist can prescribe hormonal, biochemical, and immunological tests, which will help determine the state of the pathology.

A neurotraumatologist uses the following diagnostic methods:

• spinal puncture (subarachnoid puncture, lumbar puncture, lumbar puncture) - is performed for diagnostic or treatment purposes. This diagnostics allows to establish hemorrhage in the subarachnoid space, its intensity, type of stroke (ischemic, hemorrhagic), to determine the inflammatory process in the meninges and other changes in the cerebrospinal fluid in many diseases of the central nervous system;
• Ultrasound (ultrasound examination) of the lumbar region, intervertebral discs allows for examination of the spinal discs, spinal canal and nerves of all parts of the spine. This method is prescribed for tumors, hernias, osteochondrosis and various abnormal conditions.
• Spondylography (X-ray) is a mandatory method of examination for various spinal injuries. X-rays of the spine are taken in three projections, which allows us to determine changes in the spinal axis, displacements and dislocations of the vertebral discs, bone deformation, etc.
• computed tomography (CT) of the spine allows you to assess the condition of the bone structure, soft tissues, blood vessels. CT images are obtained in various planes, and a three-dimensional image can also be made. CT of the brain, skull, soft tissues, and vessels of the head helps the doctor to determine various injuries and diseases of the skull and brain. This method also allows you to plan the patient's treatment more effectively. This method of research provides the specialist with more detailed information about the disease, traumatic brain injury, stroke, various formations in the brain, etc.;

• myelography is a special method of examination, which consists of introducing a special substance into the subarachnoid space, which surrounds the spinal cord and nerve roots, after which an image of the damaged area is taken. Usually, this method is prescribed for compression of the spinal cord or nerve roots, intervertebral hernia, and stenosis of the spinal canal;
• MRI (magnetic resonance imaging) allows the doctor to examine the anatomical structure of the vertebrae and intervertebral discs, the spinal cord, and the space between the vertebrae. This method of examination helps in diagnosing diseases and effectively treating various diseases;
• electromyography – allows you to conduct a study of the electrical activity of muscles. As a rule, this diagnostic is usually prescribed in combination with electroneurography. Electromyography is used to diagnose nerve compression, injuries, pathologies of the nerve roots and other nervous and muscular diseases.

What does a neurotraumatologist do?

A neurotraumatologist in his practice deals with the diagnosis and treatment of craniocerebral injuries, various pathologies and damage to the spinal cord, spine, and eliminates the consequences of these disorders (bruises, defects, bone fragments, abscesses, etc.).

Traumatic brain injuries are most often caused by mechanical damage to the skull and internal structures (vessels, nerves, meninges, brain). Such injuries usually occur in road accidents, falls, at work, and sports or domestic injuries to the skull are also possible.

No less dangerous to life are injuries to the spine. With fractures of the vertebrae, injuries to the intervertebral discs, spinal cord, adjacent muscles, and nerve roots often occur. The consequences of such injuries can be very different, everything depends on the type of fracture. For example, with an unstable intervertebral disc, there is always pain in the spine, such a condition can lead to a disruption of the spinal cord, blocking of nerve impulses, which will limit mobility. In this case, the patient cannot move without outside help. In such conditions, a consultation with a neurotraumatologist is mandatory. The doctor will help to establish the cause of the disease and prescribe effective treatment.

What diseases does a neurotraumatologist treat?

A neurotraumatologist deals with patients with injuries to the spine (spinal cord), skull, brain, as well as with various neoplasms in the spinal cord or brain, with intervertebral hernias, etc. The specialist also eliminates the consequences caused by trauma (removal of hematomas, bruises, bone fragments that put pressure on the brain, stabilization of the spine, etc.).

The diseases that the specialist deals with are caused mainly by various mechanical injuries (impacts, falls, etc.), which can cause quite serious consequences for a person, up to and including complete immobilization.

Skull injuries, fractures of the cervical vertebrae, spine - all these injuries lead to serious conditions, entail damage to adjacent vessels, nerve endings, organs, etc.

In addition to various types of injuries, a neurotraumatologist treats various tumors in the spinal cord, brain, intervertebral hernias, etc., which also disrupt the functioning of the nervous system.

However, this is not a complete list of diseases that the specialist treats, if we speak in general that the doctor treats conditions that have led to injuries to the human nervous system, as well as eliminating the consequences of such damage.

Advice from a neurotraumatologist

The spine is not only the foundation for the skeleton, but also a kind of protection for the spinal cord. It is for this reason that spinal injuries are considered the most severe and dangerous for human health and life.

Contusions and spinal cord injuries can deform the skeleton, paralyze the limbs, and disrupt the function of the pelvic organs.

If a spinal injury occurs, the injured area should be kept as still as possible. The victim should be very carefully placed on a stretcher (can be replaced with boards, a wooden shield, etc.), and the spine should never be allowed to bend.

Spinal injuries include fractures, displacements, and dislocations of vertebrae. Such injuries are dangerous because the spinal cord passes through the spine and can be compressed by displaced bone fragments. If the spinal cord is damaged (ruptured), the person completely loses sensitivity and paralysis of the lower part of the body occurs.

In case of cervical vertebral fractures, the neck should be wrapped with a thick layer of cotton wool and bandaged on top. After this, the victim should be placed on a stretcher, and pillows (or folded clothes, blankets, etc.) should be placed under the head and neck. Hospitalization in case of neck fractures or spinal injuries is mandatory.

The abdomen is the most vulnerable place. The walls of the peritoneum are formed by connective tissue and muscles, and many vital organs are not protected by bones. Given this, abdominal injuries can have varying degrees of severity. With abdominal injuries, an infection can be introduced into the blood, which can cause blood poisoning and death. Some abdominal injuries lead to severe bleeding, which in most cases can only be stopped by surgery. In case of abdominal injuries, the victim must be given complete rest and the wound must be covered with a sterile bandage (to reduce blood loss). If internal organs (omentum, intestinal loops) have fallen out of the peritoneum during the injury, they must be covered with a bandage soaked in petroleum jelly. A person with abdominal injuries should not be given anything to drink or eat, and painkillers should not be given to the victim before being examined by a doctor.

The entire skeleton rests on the pelvic bones, and many important organs are located there. Pelvic bone fractures can cause damage to the internal organs located there (bladder, rectum, genitals, etc.), nerves, and blood vessels. Therefore, pelvic bone injuries are among the most severe types of injuries. If the pelvis is damaged, the victim should be placed on a hard stretcher, legs slightly bent (put pillows or bundles of clothes, blankets, etc. under the knees) and wait for the ambulance to arrive.

[ 4 ]