If you’ve been referred to a neurosurgeon after an MRI, try not to worry. A referral to a neurosurgeon is a common next step in many situations and doesn't necessarily mean anything serious. Your clinician is simply making sure you get the right expert care for whatever your MRI has shown. 

We’ll help you understand the difference between neurosurgeons and neurologists and why you may need to see a neurosurgeon. We’ll also look at the conditions and disorders neurosurgeons treat and how they do that, whether by surgery, medication or other treatment, such as physical therapy. 

What is a Neurosurgeon?

A neurosurgeon is a doctor who specialises in diseases and conditions associated with the nervous system (neurological), which includes the brain, the spinal cord, and all the nerves throughout the body (peripheral). They can diagnose and treat some of the most severe and complicated medical problems that can affect people.

A neurosurgeon is highly trained in using surgery to treat and manage neurological conditions, such as:

• Brain, spinal, and skull tumours

• Head and spinal cord injuries

• Degenerative spine conditions

• Cerebral aneurysms and strokes

• Epilepsy

• Movement disorders, such as Parkinson’s disease

• Congenital conditions (present from birth), like spina bifida

• Hydrocephalus (fluid buildup in the brain)

• Pituitary tumours and neuroendocrine conditions

• Surgical management of chronic pain

Neurosurgeons use powerful imaging tools like MRI and CT scans to see inside the body and make a diagnosis. While they often perform surgery, they’ll also work with other specialists, such as neurologists, oncologists and physical therapists, to ensure you get the best treatment.

Neurosurgeon vs Neurologist

While neurosurgeons and neurologists specialise in treating disorders related to the brain, spine, and nervous system, their methods differ. While a neurosurgeon will focus on surgical treatments, a neurologist will focus on non-surgical treatments, such as medication, physical therapy or other minimally invasive treatments.

You’re more likely to be referred to a neurologist if your condition doesn’t need surgery, such as migraines, seizures, multiple sclerosis or stroke recovery. 

Why You Might Be Referred to a Neurosurgeon After an MRI

First, try not to worry if you’ve been referred to a neurosurgeon. It doesn’t necessarily mean that you need surgery. It just means that something has shown up in your MRI results that needs a closer look and an expert opinion. 

A wide variety of neurological conditions can be managed without surgery. However, your neurosurgeon will be able to look at the results of your MRI and determine whether you need surgical evaluation or treatment. 

Conditions Treated By Neurosurgeons

Here’s a breakdown of key conditions that neurosurgeons can treat, how they’re diagnosed (including the role of MRI), and how surgery may be used as part of the overall treatment plan. :

Head Injuries

Head injuries can range from mild concussions to more severe trauma like skull fractures or bleeding in the brain.

Doctors often use MRI or CT scans to check for brain damage, swelling, or bleeding. If the injury is serious, a neurosurgeon may need to operate to relieve pressure, remove blood clots, or repair skull fractures.

Chronic Headaches and Migraines

These are severe, frequent headaches or migraines that can disrupt your day-to-day activities.

MRI is sometimes used to rule out serious structural issues like tumours. However, headaches are usually diagnosed based on symptoms.

If a structural problem, like a tumour or malformation, is causing the headaches, a neurosurgeon might perform surgery to address it.

Multiple Sclerosis

A disease where the immune system mistakenly attacks the protective covering of nerves, causing damage.

MRI is critical in detecting lesions or brain and spinal cord damage. While neurosurgeons don’t usually treat MS directly, they may help manage complications like severe pain or muscle stiffness through surgery if other treatments don’t work.

Seizure or Epilepsy

These are conditions where abnormal electrical activity in the brain causes seizures.

MRI checks for any structural issues, such as tumours, that might be causing the seizures.

If medications don’t control the seizures, a neurosurgeon might perform surgery to remove the part of the brain causing the seizures or implant a device to help regulate brain activity.

Parkinson's Disease

Parkinson’s is a movement disorder where specific brain cells deteriorate, leading to tremors, stiffness, and difficulty with movement. MRI can help rule out other conditions, but Parkinson’s is mainly diagnosed based on symptoms.

For severe cases that don’t respond to medication, a neurosurgeon can implant a deep brain stimulator (DBS) device to help manage symptoms.

Stroke

A stroke happens when blood flow to the brain is interrupted, leading to brain damage. MRI or CT scans are crucial for determining the type and severity of the stroke.

In some cases, a neurosurgeon may need to remove a blood clot, repair damaged blood vessels, or relieve brain swelling.

Brain Tumours

Tumours are abnormal growths in the brain that can be either benign (non-cancerous) or malignant (cancerous). MRI is the primary tool for detecting brain tumours.

A neurosurgeon may remove the tumour, perform a biopsy to find out if it's cancerous or treat it using radiation.

Spinal Cord Tumours

These are tumours that grow inside or around the spinal cord, which can lead to pain, weakness, or numbness. MRI helps locate and assess the tumour.

Neurosurgeons can surgically remove or reduce the tumour to relieve pressure on the spinal cord and improve symptoms.

Spinal Fractures

These are breaks or cracks in the vertebrae, often due to injury or conditions like osteoporosis. MRI or CT scans help assess the extent of the fracture.

A neurosurgeon may stabilise the spine using screws, plates, or rods and sometimes perform spinal fusion to help the bones heal.

Aneurysms

An aneurysm is a weak, bulging area in a blood vessel in the brain, which can burst and cause dangerous bleeding. MRI or MRA (Magnetic Resonance Angiography) can detect aneurysms and assess their risk of bursting.

Neurosurgeons can perform procedures to repair the aneurysm and prevent it from rupturing.

Arteriovenous Malformations (AVMs)

AVMs are abnormal tangles of blood vessels in the brain or spine that can cause bleeding or neurological problems. MRI and angiography help detect AVMs and their potential for harm.

Neurosurgeons may surgically remove the AVM or use other treatments to prevent bleeding and improve symptoms.

Hydrocephalus

A condition where excess fluid builds up in the brain, causing pressure and swelling. MRI or CT scans reveal enlarged fluid spaces in the brain.

Neurosurgeons can insert a shunt to drain the excess fluid or perform a procedure to reduce pressure in the brain.

Spinal Cord Injuries

Damage to the spinal cord can result in paralysis or loss of sensation. MRI shows the extent of the injury and any swelling or fractures.

Neurosurgeons may stabilise the spine and perform surgery to relieve pressure on the spinal cord, aiding recovery.

Spinal Stenosis

This is a condition where the spinal canal narrows, putting pressure on the spinal cord and nerves. MRI for spinal stenosis helps visualise the narrowing and its effects on nearby nerves.

Neurosurgeons can perform decompression surgery to relieve pressure and ease symptoms like pain and numbness.

Herniated Discs

A herniated disc occurs when one of the spinal discs ruptures or bulges, pressing on nearby nerves. MRI for a herniated or slipped disc is used to confirm the damage and its impact on surrounding nerves.

Neurosurgeons may perform surgery to remove or repair the damaged disc and relieve pressure on the nerves.

Scoliosis

Scoliosis is an abnormal curvature of the spine, which can cause pain or difficulty breathing if severe. MRI can help assess the curve and rule out other conditions.

For severe cases, a neurosurgeon may perform spinal fusion surgery to correct or stabilise the curvature.

Pituitary Tumours

These tumours develop in the pituitary gland, affecting hormone production and overall health. MRI is critical to detecting pituitary tumours and assessing their size and impact.

Neurosurgeons can remove pituitary tumours using minimally invasive techniques, often through the nose, to minimise recovery time.

Surgeries Performed By Neurosurgeons

Neurosurgeons do many different operations on the brain, spine, and nerves. These surgeries can help with serious health problems and often improve people's lives. Here's a list of some common surgeries neurosurgeons do:

• Craniotomy: Opening the skull to access the brain for tumour removal, blood clot evacuation, or to relieve pressure.
• Laminectomy: Removing part of the vertebra to relieve pressure on the spinal cord or nerves, often due to spinal stenosis.
• Spinal fusion: Joining two or more vertebrae to stabilise the spine after injury or to correct deformities.
• Discectomy: Removing a herniated disc pressing on spinal nerves to relieve pain and restore function.
• Aneurysm clipping or coiling: Surgical procedures to repair brain aneurysms and prevent them from rupturing.
• Deep Brain Stimulation (DBS): Implanting a device that sends electrical impulses to targeted brain areas to manage symptoms of Parkinson's disease and other movement disorders.
• Stereotactic surgery: Using advanced imaging techniques to precisely locate and treat tumours or abnormalities in the brain with minimal impact on surrounding tissue.
• Shunt placement: Inserting a shunt to drain excess cerebrospinal fluid in conditions like hydrocephalus.
• Tumour resection: Removing brain or spinal tumours to alleviate symptoms and improve health.

Less commonly, neurosurgeons may perform foetal surgery, where they operate on babies in the womb to treat conditions such as spina bifida.

Non-Surgical Treatments

In addition to surgery, neurosurgeons may recommend non-surgical treatments to manage neurological conditions. These treatments can help relieve symptoms and improve your quality of life without invasive surgery. They may include:

• Medication: Prescribing medication to manage pain, seizures, or other neurological symptoms.
• Physical therapy: Working with physical therapists to improve your mobility, strength, and function after an injury or surgery.
• Occupational therapy: Helping you re-develop the skills needed for living and working, especially after neurological conditions.
• Pain management: Using techniques such as nerve blocks, epidural injections, or medication management for chronic pain relief.
• Lifestyle changes: Encouraging diet, exercise, and stress management changes to support your health and well-being.
• Vagus Nerve Stimulation (VNS): If you have epilepsy that doesn’t respond to medication, this device may be implanted to help control seizures.

What to Expect at an Appointment With a Neurosurgeon

When you attend an appointment with a neurosurgeon after an MRI scan, there are a few things to expect to help you prepare. You can bring a relative, close friend, or carer for support during your visit and to help you remember anything important. The hospital or clinic will let you know if there is anything specific you need to bring with you beforehand.

Your consultant neurosurgeon will start by taking a detailed medical history from you and conducting a physical examination. They’ll go through your MRI findings with you and explain what they mean. 

The following steps are dependent on your neurosurgeon’s diagnosis. You may be referred for more diagnostic tests and a follow-up appointment, or you may be referred for treatment, which may or may not include surgery. For some people, a ‘watch and wait’ approach with regular check-ups is recommended instead. It very much depends on what your neurosurgeon has found in your MRI results.

Find an MRI Scan Near You

Skip the NHS waiting lists and book a private MRI scan near you today with Scan.com. We can help you fast-track your diagnosis and treatment without GP referrals. An expert clinical consultation can also help you decide if an MRI scan is right for you. Choose from over 150 centres nationwide with flexible appointment times and get fast online results, including a digital imaging report. It’s easier than ever to get your health back on track.

Sources:

Neurosurgeon. (2022). https://my.clevelandclinic.org/health/articles/22364-neurosurgeon

Neurosurgery. (2024). https://www.cuh.nhs.uk/my-planned-care-a-z/neurosurgery-generic-cranial-neurosurgical-procedure/

Neurosurgery. (N.D.). https://www.uclh.nhs.uk/our-services/find-service/neurology-and-neurosurgery/neurosurgery

NHS STANDARD CONTRACT FOR NEUROSURGERY (ADULT). (2018). https://www.england.nhs.uk/wp-content/uploads/2018/08/Neurosurgery-adult.pdf

The Complete Guide To Becoming A Neurosurgeon. (2021). https://www.bmj.com/careers/article/the-complete-guide-to-becoming-a-neurosurgeon