Neurosurgical conditions

What it means: Part of an intervertebral disc extends beyond its usual boundary and may irritate a nerve supplying the leg. Pain can travel as far as the foot and may be accompanied by altered sensation or weakness.

Assessment: The starting point is a clinical examination. MRI may be recommended depending on the symptoms, their duration and severity.

Treatment options: Many people improve with appropriate activity, pain treatment and targeted physiotherapy. Surgery may be considered for persistent severe symptoms or nerve damage. New bladder problems or numbness around the groin require immediate assessment.

Further information: AANS

What it means: A herniated disc in the neck can compress a nerve root, causing pain, tingling, reduced sensation or arm weakness. A disc abnormality on MRI does not necessarily explain all symptoms.

Assessment: The clinician assesses strength, sensation and reflexes. MRI or nerve tests, such as electromyography (EMG), may be needed.

Treatment options: Non-surgical treatment is usually considered when appropriate. Surgery may be an option for worsening weakness, spinal cord compression or persistent significant pain despite treatment.

Further information: AANS

What it means: Spinal stenosis means that the space available for nerves in the spinal canal has narrowed. Symptoms may include leg pain, tingling or weakness when standing or walking, often easing when sitting down or bending forward.

Assessment: Diagnosis is based on the examination and MRI. Circulation problems that can also cause leg pain need to be considered.

Treatment options: Physiotherapy, adjusting activities and pain treatment may help. Surgery to relieve pressure on the nerves can be considered when walking is substantially limited or neurological symptoms are present. Spinal stabilisation is added only in selected cases.

Further information: AANS

What it means: Narrowing of the spinal canal in the neck can damage the spinal cord. This is called cervical myelopathy. A person may drop objects, struggle to fasten buttons or feel unsteady when walking. Neck pain may be mild or absent.

Assessment: A neurological examination and MRI of the cervical spine are important. Progressive symptoms should be assessed without delay.

Treatment options: Surgery to relieve pressure on the spinal cord is often recommended for significant or worsening myelopathy. The main aim is to prevent further damage. The extent of recovery also depends on how severe and longstanding the damage is.

Further information: AANS

What it means: One vertebra slips relative to the adjacent vertebra. This may result from wear-related changes or a defect in part of the vertebra. Not every slip causes pain or instability, but in some people it narrows the space for nerves.

Assessment: X-rays show vertebral alignment. MRI assesses the nerves and discs. Sometimes X-rays taken during movement are needed.

Treatment options: Treatment depends on the symptoms and spinal stability. Options include exercise and pain management. Selected cases may benefit from surgery to decompress the nerves, sometimes with spinal stabilisation.

Further information: AANS

What it means: A vertebra can fracture following an injury. With osteoporosis, a fracture may occur after a relatively minor strain. Some fractures are stable; others threaten the spinal cord or nerves. New weakness or altered sensation after an injury is a warning sign.

Assessment: X-rays, CT or MRI are used depending on the situation. Assessment considers the stability of the fracture and the condition of the nerves and spinal cord.

Treatment options: Options include pain relief, sometimes a brace, and gradual rehabilitation. Selected fractures may require vertebral augmentation or surgical stabilisation. When osteoporosis is present, treatment also needs to address the weakened bones.

Further information: AANS

What it means: Tumours can affect the vertebrae, the coverings of the spinal cord or the cord itself. They may be benign, malignant or metastases from a cancer elsewhere in the body. Even a benign tumour can be serious if it compresses the spinal cord.

Assessment: MRI, often with contrast, is usually a key investigation. Further tests depend on the suspected diagnosis.

Treatment options: Treatment depends on the tumour type, pressure on neurological structures and spinal stability. Options include monitoring, surgery, radiotherapy or systemic cancer treatment. New leg weakness or bladder problems require urgent assessment.

Further information: AANS

What it means: Most meningiomas grow slowly and are benign. They are often found incidentally. Depending on their location, they can cause seizures, limb weakness, visual problems or other neurological symptoms.

Assessment: MRI shows the size of the tumour and its relationship to surrounding structures. During monitoring, scans are compared over time.

Treatment options: A small tumour without symptoms may sometimes be monitored. Surgery or focused radiation treatment may be considered if it grows or causes symptoms. Age, general health and treatment risks also matter. “Benign” does not mean that a tumour cannot cause problems.

Further information: AANS

What it means: These tumours are usually benign. They may produce excess hormones or interfere with normal pituitary function. A larger tumour may press on the visual pathways, particularly affecting peripheral vision.

Assessment: Assessment includes pituitary MRI, hormone blood tests arranged by an endocrinologist and, when indicated, an eye examination including visual field testing.

Treatment options: Options include monitoring, medication or surgery, often using an endoscopic approach through the nose. Prolactinomas are usually treated with medication first. The approach depends on tumour type, hormone function and vision. Reduced pituitary function alone does not automatically mean surgery is needed.

Further information: AANS

What it means: Gliomas arise from cells of the supporting tissue of the nervous system and have different biological characteristics. Brain metastases originate from cancer elsewhere in the body. Symptoms may include seizures, weakness, speech difficulties or behavioural changes.

Assessment: MRI assesses the location and extent of the lesion. The precise tumour type often requires a tissue sample, including molecular testing.

Treatment options: A specialist team considers safe tumour removal or a biopsy, followed by treatment guided by the results. This may include radiotherapy or medicines. The aim is to control the disease while preserving neurological function as far as possible.

Further information: National Cancer Institute

What it means: Typical symptoms include gradual hearing loss in one ear, tinnitus or unsteadiness. Larger tumours can cause additional neurological symptoms.

Assessment: MRI and hearing tests help establish the diagnosis. The rate of growth is also important.

Treatment options: Monitoring, focused radiation treatment or surgery may be considered according to tumour size, growth, hearing and general health. Planning aims to protect facial nerve function and hearing, although preservation cannot be guaranteed in every case.

Further information: NHS

What it means: The ventricles can enlarge when cerebrospinal fluid does not drain or get absorbed normally. Symptoms depend on the cause and how quickly it develops. In older adults, normal pressure hydrocephalus often causes difficulty walking, slowed thinking and urinary control problems.

Assessment: Assessment includes a neurological examination and CT or MRI. When normal pressure hydrocephalus is suspected, tests may assess the response to removing cerebrospinal fluid.

Treatment options: Treatment may involve a drainage system called a shunt. Endoscopic creation of a new fluid pathway is suitable for some types, particularly those involving an obstruction. Not every case of enlarged ventricles requires surgery.

Further information: AANS

What it means: The median nerve is compressed at the wrist. Symptoms usually affect the thumb, index and middle fingers and part of the ring finger; the little finger is usually spared. Symptoms may wake a person at night and ease when the hand is shaken.

Assessment: The clinician examines the hand. Nerve conduction studies, EMG or other nerve investigations may be recommended.

Treatment options: For milder symptoms, a night splint and changes to activities may help, sometimes with a local injection. Surgery to release the nerve may be considered for marked compression, weakness or symptoms that persist despite non-surgical treatment.

Further information: NHS

What it means: The ulnar nerve may be compressed around the elbow. Symptoms are often worse after keeping the elbow bent or leaning on it for a long time. Advanced damage can cause weakness of the small hand muscles.

Assessment: A clinical examination and, when needed, EMG help identify where and how severely the nerve is affected.

Treatment options: Reducing pressure on the elbow and prolonged bending may help initially; a splint is sometimes used. Surgical release may be considered for persistent or worsening symptoms. Advanced nerve damage may not recover completely.

Further information: NHS

What it means: The pain often feels like an electric shock and may be triggered by touch, chewing, talking or brushing the teeth. Contact between a blood vessel and the nerve is one possible cause, but facial pain can have other causes.

Assessment: Diagnosis is based on the pattern of pain and a neurological examination. MRI helps identify the cause and exclude other conditions.

Treatment options: Medication is usually the first option. If it does not help or causes significant side effects, options may include surgery to separate a vessel from the nerve, a procedure on the nerve or stereotactic radiation treatment. The choice depends on the findings and general health.

Further information: NHS

What it means: An aneurysm is a bulge in an artery wall. An arteriovenous malformation (AVM) is an abnormal connection between arteries and veins. Some findings cause no symptoms; others may cause seizures, neurological problems or bleeding.

Assessment: CT or MR imaging of the blood vessels is used, sometimes with catheter angiography.

Treatment options: A specialist team balances the risks of bleeding and treatment. Options include monitoring, surgery or treatment from inside the blood vessels; some AVMs can also be treated with focused radiation. A sudden exceptionally severe headache requires immediate emergency help.

Further information: NHS

What it means: When a blood vessel ruptures, blood collects within the brain tissue. This is a haemorrhagic stroke. At home, its symptoms cannot reliably be distinguished from those of a stroke caused by a blocked vessel.

Assessment: Urgent hospital assessment and a brain CT scan are essential. Imaging of the blood vessels and blood-clotting tests may also be needed.

Treatment options: Treatment includes monitoring vital functions, controlling blood pressure and addressing the cause of bleeding. Surgery or drainage may be considered in selected patients, depending on the location and extent of bleeding and the clinical condition. If a stroke is suspected in Slovakia, call 155 or 112.

Further information: NICE

What it means: It often follows a head injury. An acute haematoma can be immediately life-threatening. A chronic haematoma may cause symptoms weeks later, even after an apparently minor injury. Symptoms include a worsening headache, sleepiness, confusion, unsteady walking or limb weakness.

Assessment: The key investigations are a neurological examination and a brain CT scan.

Treatment options: A small, stable collection may sometimes be monitored. If it presses on the brain or causes significant symptoms, it may need surgical removal, often with temporary drainage. For reduced consciousness or new weakness, call 155 or 112 in Slovakia.

Further information: NHS