Do I really need surgery for my brain condition?

Whether you need surgery depends on three things: the diagnosis, your symptoms, and what happens if we do nothing. All three have to point in the same direction before I will recommend an operation.

Some conditions almost always need surgery — a large tumour causing pressure, a ruptured aneurysm, symptomatic hydrocephalus. Others rarely do — small incidental meningiomas, unruptured aneurysms below a certain size, or a disc bulge without nerve compression.

Many conditions sit in the middle. Here we watch closely: repeat imaging at set intervals, monitor symptoms, and intervene only if something changes. Watchful waiting is a real treatment decision, not a lack of one.

If I recommend surgery, I will explain exactly why the balance tips that way for you. If I recommend against, I will explain what would change my mind and when to come back.

You are always entitled to a second opinion. For a decision this important, seek one if it will help you feel confident. I will happily share your notes and imaging with another neurosurgeon.