Eight topics that account for most of what walks into a neurosurgical clinic. They are written for the moment you leave an office holding a scan and a word you do not understand, and written by the same rule as the rest of this publication: the figures are the ones that exist, including the ones that are not reassuring.
Most people reading these pages will not need an operation. That is stated on every one of them, with the numbers next to it.
Between 85 and 90 per cent of lumbar herniated discs stop hurting within six to twelve weeks without anyone operating on them, and two out of three resorb on their own. Fewer than one in ten end up in an operating theatre. This page is about how to work out which group you are in.
Read →It is the reason many people over sixty stop walking any distance. Almost half the people of that age have a narrowed canal on imaging and most of them have no symptoms at all, so the MRI on its own is never enough to decide anything.
Read →In the reference population study, which followed 561 people for almost five years, 74 per cent never needed surgery and 90 per cent ended up with no symptoms or only mild discomfort. Only 15 per cent could recall a strain or an injury before it began.
Read →The words "brain tumour" and "cancer" are not synonyms, and the difference is not a matter of wording: 74 per cent of primary brain tumours are not malignant, and their five-year relative survival is 92 per cent. This page is for the stage where you still do not know which of the two you are dealing with.
Read →In the largest international study, aneurysms of less than seven millimetres in the anterior circulation, in people who had never had a haemorrhage, carried a five-year rupture risk of zero per cent. Having an aneurysm is not the same as needing an operation.
Read →The same word names two very different situations: parents who are told their baby has large ventricles, and a family watching an older relative walk worse and worse and forget things. This page is written for both.
Read →It is probably the most intense pain medicine describes, and it is also the one that most often ends in an unnecessary tooth extraction. Of every ten patients who reach surgery, eight saw a dentist first, and more than half of them had something done in the mouth that was not needed.
Read →If you are reading this at three in the morning with a child in your arms, start with the red box. The rest can wait until tomorrow. And no, you do not have to keep them awake: that is a myth, and what you should be doing is something else.
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