What happens during a neurosurgery consultation, step by step

Step one is the history — usually the longest part of the visit. I will ask about your symptoms, their timeline, what makes them better or worse, previous treatments, other medical conditions and medications, family history, and how the problem is affecting your work and home life.

Step two is the examination. This is focused on the nervous system relevant to your complaint — cranial nerves and cognition for brain problems, motor and sensory testing for spine problems. I may ask you to walk, do a heel-to-toe test, or check specific reflexes.

Step three is the imaging review. We will look at your MRI or CT together on a large screen. I will show you exactly what I am seeing, and how it correlates with your symptoms and examination.

Step four is the plan. This might be no further action, a repeat scan in six months, a course of physiotherapy or a nerve root injection, referral to another specialist, or a discussion about surgery. If surgery is on the table, we will talk through risks, benefits, alternatives and expected recovery.

You will leave with a written summary and my rooms' contact details. Follow-up questions in the days after are welcome — many patients think of things on the drive home.