Is brain surgery safe? Understanding the real risks

Brain surgery today is not what it was thirty years ago. Neuronavigation, intraoperative monitoring, high-magnification microscopes and refined anaesthesia have transformed outcomes. The majority of elective procedures are performed with very low rates of serious complication.

That said, no operation is risk-free. General surgical risks include bleeding, infection, and complications of anaesthesia. Neurosurgery-specific risks include stroke, seizure, cerebrospinal fluid leak, and a neurological deficit related to the area operated on — weakness, speech disturbance or vision change.

The size of these risks depends entirely on the operation and the patient. Removing a small meningioma at the surface of the brain in a healthy 45-year-old is a different conversation to operating on a deep-seated tumour near the speech area in someone with heart disease.

Before every operation I will give you the specific numbers for your procedure — not generic percentages. You will hear the worst plausible outcome as well as the expected one, so your consent is genuinely informed.

The most important risk to weigh is the risk of doing nothing. For many conditions, the natural course is worse than the operation. That comparison — surgery versus no surgery — is the one that actually matters.