When should I see a neurosurgeon about a brain condition?
Come in if imaging found a mass, cyst, fluid buildup, or bleeding; if your doctor referred you; or if you have new or worsening headaches, balance or walking problems, memory changes, or a first seizure. Many findings only need monitoring, and knowing that early is a relief.
Brain conditions we evaluate and treat
Brain tumors
What it isAn abnormal growth in or around the brain. Meningiomas grow from the brain’s covering and are usually noncancerous and slow growing. Other tumors start in brain tissue (gliomas) or spread from cancer elsewhere in the body (metastatic tumors).
What causes itMost have no known cause. Known risk factors include prior radiation to the head and, for meningiomas, older age and female sex.
How it’s treatedSmall, slow-growing tumors without symptoms are often watched with regular MRI scans. Tumors that grow or cause symptoms may be removed surgically by Dr. Mignucci. Some patients need radiation or other treatment, coordinated with oncology.
When to come inAny tumor found on a scan, even without symptoms, deserves a neurosurgeon’s review.
Normal pressure hydrocephalus
What it isA buildup of fluid in the brain’s ventricles, most common in adults over 60. The classic signs are trouble walking, needing to urinate urgently, and memory or thinking changes. It is sometimes mistaken for dementia or Parkinson’s disease.
How it’s treatedTesting may include imaging and a lumbar puncture to see if removing fluid improves walking. If it does, a shunt can drain extra fluid. Walking often improves the most, though results vary by person.
Chiari malformation
What it isThe lowest part of the brain extends into the opening at the base of the skull. Many people have no symptoms and find out from a scan done for another reason.
SymptomsHeadaches at the back of the head that worsen with coughing or straining, neck pain, dizziness, or numbness.
How it’s treatedObservation if there are no symptoms. Surgery (decompression) is considered for persistent symptoms or a fluid-filled cavity in the spinal cord.
Chronic subdural hematoma
What it isA slow collection of blood between the brain and its covering, often weeks after a minor fall or bump, especially in older adults and people taking blood thinners.
SymptomsHeadache, confusion, weakness, or trouble walking that develops gradually.
How it’s treatedSmall ones may be watched. Larger or symptomatic ones are drained through small openings in the skull.
Second opinions
If you have been told you need brain surgery, a second opinion is reasonable and common. Bring your imaging and the recommendation you received.
Recovery and realistic expectations
Recovery depends on the condition, the treatment, and your overall health. Some patients go home within a day or two of surgery; others need longer hospital stays and rehabilitation. Dr. Mignucci will give you a specific plan for your situation.
Go to the ER or call 911 if you have:
A sudden, severe headache; sudden weakness, numbness, or drooping on one side; trouble speaking; sudden vision loss; or a seizure lasting more than five minutes.
Common questions
Do I need a referral to see Dr. Mignucci?
Many plans do not require one, but some HMO plans do. Our financial counselor checks this when you request an appointment.
Should I bring my previous brain scans?
Yes. Bring the disc and the written report, or ask the imaging center to send them before your visit. The images themselves matter more than the report.
Does a brain tumor mean cancer?
No. Many brain tumors, including most meningiomas, are noncancerous. Dr. Mignucci will explain what your imaging shows.
Can I bring a family member?
Please do. A second set of ears helps, and we are happy to answer their questions too.
Related
This page is for general education and is not medical advice or a diagnosis. Talk with your doctor about your own symptoms and treatment options.