Physician's Area

WHEN TO REFER TO A NEUROSURGEON

  • Do the MRI scan if:
    • leg or arm pain not improving after 6 weeks
    • significant weakness
    • history of cancer
    • symptoms suggestive of infection
  • Refer to neurosurgeon if:
    • leg or arm pain not improving after 6 weeks
    • significant weakness
    • symptoms of cauda equina dysfunction
    • neck or back pain persist beyond 6 weeks
  • Refer to neurosurgeon/spinal surgeon  if:
    1. significant arm or leg pain, or weakness
    2. suspected cauda equina syndrome
    3. suspected spinal abscess
    4. suspected or proven tumour
  • Refer to pain specialist if neck or back pain is the main complaint, or if has seen several surgeons previously and surgery was not recommended

BRAIN TUMOURS

  • Small brain tumours without surrounding oedema and headaches can be seen within a week and should be referred to a neurosurgeon
  • Larger brain tumours (3cm or more) with headaches, surrounding oedema or mass effect, or any neurological deficits should be seen sooner
  • If cerebral oedema seen on CT or MRI around a tumour, consider starting dexamethasone 2-4mg orally tds or qid (also use a gastroprotective agent)
  • If an intracranial mass is reported as showing ‘ring enhancement’ on CT or MRI, an abscess is a possibility and this is even more urgent- the case should be discussed with a  neurosurgeon
 



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Aneurysmal Bone Cyst

Arterios Venous  

Brain Tumor Epidermoid

Carotid Endarterectomy

Carpal Tunnel Syndrome

Cervical Disc Surgery

Corpectomy

Craniopharyngioma

Cranioplasty Surgery

Craniovertebral Anomaly

Fibrous Dysplasia

Giant Aneurysm

Minimally Invasive Spine Surgery

Olfactory Groove Meningioma  

Sacral Fracture

Skull Base Meningioma

Spinal Tumor

Stereotaxy

Vertebroplasty