Non-surgical alternatives to brain surgery

The right treatment for a brain condition is not automatically surgery. For a small meningioma found by chance on a scan, the best treatment is often to watch it with an MRI in a year and see if it grows.

For many brain metastases, small aneurysms and certain benign tumours, stereotactic radiosurgery (Gamma Knife, CyberKnife) delivers a highly focused dose of radiation without an incision. It is not a substitute for surgery in every case, but where it applies it is genuinely non-invasive.

For most aneurysms, endovascular treatment (coiling or flow diversion, done through a groin catheter) has replaced open surgery as the first-line option. It is done by interventional neuroradiologists working closely with neurosurgeons.

Some conditions previously treated surgically — for example many pituitary tumours — are now managed medically with drugs that shrink them.

I will always tell you honestly if there is a good non-surgical option for your condition, even if it means referring you elsewhere. Doing the right thing is more important than doing the operation.