Brain and Spine Surgery (Neurosurgery)

Brain and spine symptoms deserve a clear diagnosis and an individual plan. MPGCARE coordinates neurosurgical appointment requests at Medical Park and Liv Hospital in Türkiye. The receiving hospital’s physicians assess the condition and explain treatment choices; an imaging finding alone does not mean an operation is needed.

Conditions assessed by neurosurgery

The specialty covers selected conditions of the brain, spinal cord, spine and nerves, working with neurology, radiology and other teams. The conditions below illustrate this scope. Symptoms can have other causes; tests and treatment are selected after examination. The hospital confirms age eligibility, the relevant team and current services.

Pituitary tumours: hormones, vision and coordinated care

Most pituitary adenomas are non-cancerous, but hormone excess/deficiency or pressure on vision pathways can be important. Discuss menstrual/sexual changes, milk discharge, growth or body changes and fatigue alongside headaches or vision symptoms. The endocrinologist selects hormone tests, which may include prolactin, IGF-1, cortisol/ACTH and thyroid-related tests; they are not a compulsory panel. Pituitary-protocol MRI and visual-field testing are chosen by the team.

Treatment depends on tumour type, hormonal activity, growth and visual impact. Prolactinomas are often treated first with medication; other selected tumours may need endoscopic transsphenoidal surgery through the nose, monitoring or radiation. Confirm an experienced pituitary team, endocrinology/eye review and postoperative hormone, sodium/fluid and imaging follow-up. Complete removal or normalisation of hormones is not guaranteed. Sudden severe headache with visual loss or reduced consciousness needs urgent local assessment.

Lower-back and neck disc operations

Neurosurgeons perform both lumbar and cervical disc surgery. When the symptoms and imaging match, persistent disabling nerve pain despite appropriate non-surgical care or a neurological deficit may lead to surgical assessment. Lumbar microdiscectomy or selected endoscopic discectomy removes the compressing disc fragment. Cervical options can include anterior discectomy with fusion, selected disc replacement or a posterior approach. Not every herniated disc needs surgery; the surgeon confirms the technique, need for implants, alternatives and risks.

Diseases, symptoms and selected tests

Condition	Symptoms and points to notice	Investigations selected by the physician
Lumbar disc herniation (lower-back herniated disc)	Back pain radiating into a leg, numbness or weakness. Increasing weakness or new bladder/bowel symptoms require urgent assessment.	Strength/reflex/sensation examination; lumbar MRI when indicated. EMG/nerve studies only if the clinical question requires them; X-rays do not show the disc itself.
Cervical disc herniation (neck herniated disc)	Neck-to-arm pain, finger numbness or weakness. Hand clumsiness and walking changes may suggest spinal-cord involvement.	Neurological examination and cervical MRI when indicated; selected CT/X-rays for bone/alignment or EMG to distinguish other nerve problems.
Spinal canal stenosis	Leg pain or reduced walking distance; cervical stenosis may cause balance problems and loss of hand dexterity. Report progression.	Neurological examination and regional MRI; selected CT or alignment X-rays. Findings must match symptoms.
Spinal cord and spinal tumours	Persistent back pain, weakness, sensory changes or bladder/bowel changes. New neurological deficits need urgent review.	Regional MRI, sometimes with contrast, and selected CT/staging tests; biopsy/pathology when the specialist team considers it appropriate.
Glioma	New seizures, progressive headache or focal neurological change. Symptoms are not specific to a tumour.	Brain MRI, neurological examination and selected tissue/molecular diagnosis; functional mapping if needed for surgery.
Meningioma	May be incidental or cause seizures, headache or focal changes depending on location. A scan alone does not determine treatment.	MRI and comparison with earlier scans; selected CT for bone involvement. Pathology if tissue is obtained.
Pituitary adenoma	Visual-field changes, headache or hormonal symptoms. Sudden severe headache with visual loss requires urgent care.	Pituitary MRI, endocrinology-selected hormone tests and visual-field assessment; multidisciplinary interpretation.
Vestibular schwannoma (acoustic neuroma)	One-sided hearing change, tinnitus or imbalance. Report the course of hearing and balance symptoms.	MRI of the relevant brain/internal auditory canal region and hearing/balance assessment as indicated.
Brain metastases	Neurological symptoms in a person with cancer, or lesions requiring investigation. Share the primary cancer and previous treatment records.	Brain MRI and selected systemic staging; pathology when required to clarify diagnosis. Oncology and neurosurgery coordinate.
Cerebral aneurysm	May be incidental. A sudden exceptionally severe headache, collapse or neurological deficit is an emergency.	Selected CT/MR angiography; urgent CT in suspected bleeding and catheter angiography when the vascular team indicates it.
Brain arteriovenous malformation (AVM)	May present with seizures or bleeding. Sudden headache or new weakness needs immediate local care.	MRI and selected vascular imaging; catheter angiography when needed for definition/planning, with separate procedural consent.
Hydrocephalus	Headache, vomiting, gait/cognitive or bladder changes; infants may have abnormal head growth. Increasing drowsiness or shunt-related deterioration is urgent.	Neurological/age-appropriate assessment, MRI/CT or selected infant ultrasound. Additional CSF/pressure tests only after specialist assessment of safety and need.
Chiari malformation	Cough-related occipital headache, balance, swallowing or limb symptoms may occur; some findings are asymptomatic.	Brain/craniocervical and selected spinal MRI; CSF-flow or other functional studies only if indicated.
Arachnoid cyst	Often an incidental finding; pressure-related headache or neurological symptoms require assessment. It does not automatically need surgery.	MRI and comparison with prior imaging; selected CT when appropriate. The specialist assesses symptoms and pressure effects.
Subdural hematoma	Head injury may be followed by headache, confusion, drowsiness or weakness, sometimes delayed. Blood thinners and new deterioration matter.	Urgent neurological assessment and CT; selected MRI and blood/coagulation tests. Treatment urgency depends on clinical findings.
Drug-resistant epilepsy	Seizures despite appropriately selected medicines warrant specialist review. Record events and medicine response; do not stop medicines.	Neurology-led assessment, EEG/video-EEG and epilepsy-protocol MRI; neuropsychological or invasive monitoring only when justified for surgical selection.
Trigeminal neuralgia	Brief shock-like facial pain triggered by touch or chewing. Other dental/neurological causes must be considered.	Clinical history/examination and selected high-resolution MRI to assess nerve/vessel relationships or other causes; no single blood test confirms it.
Parkinson’s disease: selected DBS assessment	Motor fluctuations, tremor or other symptoms may prompt movement-disorder review. DBS is not a cure or appropriate for every patient.	Neurology-led diagnosis, medication-response and motor assessment, cognition/mood evaluation and planning MRI; ongoing device programming is required.

Consultation, investigations and procedures

Consultation includes symptoms, neurological examination, strength, sensation, walking, current medicines and previous treatment. MRI, CT, blood tests or other investigations answer specific questions. Biopsy, catheter angiography, surgery and implanted-device procedures require separate indications, consent and planning. MRI contrast, sedation and laboratory tests are not mandatory for everyone; report kidney disease, allergies, pregnancy and implants.

Is surgery appropriate for me?

The team compares monitoring, medicines, rehabilitation, surgery and other options against the diagnosis, symptoms, progression, general health and your priorities. Tumour treatment may require a multidisciplinary review and tissue diagnosis. Discuss the proposed goal, alternatives and what may happen without treatment. Surgery may remove tissue, relieve pressure or stabilise structures, but cannot guarantee cure, pain relief or recovery of lost function.

Methods and risks: confirm the individual plan

Microsurgery, endoscopy, decompression, fusion, vascular/endovascular procedures, epilepsy surgery or deep brain stimulation are used for selected indications. Availability and suitability must be confirmed by the relevant centre. Discuss bleeding, infection, anaesthesia, neurological deficits, cerebrospinal-fluid leakage and condition-specific risks; a small incision does not mean no risk. Ask about intensive care, rehabilitation, possible revision and who manages complications and controls.

Gamma Knife: what does it mean?

Gamma Knife is a form of stereotactic radiosurgery using focused radiation. It does not open the skull or remove the lesion as an operation does. It may be considered for selected tumours, vascular malformations or trigeminal neuralgia after specialist review. It does not replace surgery for every lesion. Benefit may develop gradually; swelling, radiation effects, persistent symptoms or retreatment can occur. The neurosurgery/radiation team confirms suitability, planning images and the follow-up schedule.

Which reports should I prepare?

Provide the symptom timeline, examination/diagnosis report, previous MRI/CT reports and original DICOM images, operation and discharge summaries, pathology/molecular results if available, and radiotherapy or radiosurgery records. Include all medicines, anticoagulants, allergies, implanted-device/shunt details and other illnesses. For epilepsy add EEG/video-EEG, seizure descriptions and medicines tried. Share records securely; the centre confirms whether updated images or translations are needed.

Second opinion and coordination with your current doctor

Explain the question: diagnosis, need for surgery, treatment alternatives, recurrence or rehabilitation. With your consent, the current and receiving teams share records, identify the responsible clinician and agree how a written opinion is communicated. Pathology slides/blocks are sent only after both laboratories confirm requirements. Remote review has limits. Continue the current prescription unless the treating clinician changes it; do not postpone urgent care.

What should patients and families pay attention to?

Keep a symptom and medication record and note changes in walking, strength, speech, vision, consciousness or seizure pattern. Ask for an emergency action plan and a named contact. Avoid independent changes to seizure medicines, steroids or blood thinners. Discuss fall prevention, safe daily activity, nutrition, psychological support and rehabilitation with the team. Children need age-appropriate explanations and a pediatric team where indicated.

Urgent symptoms: seek local care immediately

Sudden severe headache, new facial droop or limb weakness, speech difficulty, reduced consciousness, an ongoing/repeated seizure without recovery or worsening symptoms after head injury require immediate local emergency assessment. New loss of bladder/bowel control, inability to pass urine, saddle numbness or rapidly increasing leg weakness may indicate a spinal emergency. Do not wait for overseas appointments or travel. Persistent but stable symptoms can be assessed through a planned consultation.

Preparation, recovery and home-country follow-up

Only the receiving centre gives patient-specific fasting, medication, wound-care and activity instructions after confirming the plan. Do not stop medicines yourself. Agree who explains imaging/pathology results, the control schedule, rehabilitation and the local clinician accepting follow-up. After shunt or device treatment, establish maintenance/programming access. New fever, wound drainage, worsening headache/vomiting or neurological change after a procedure needs prompt team contact or emergency assessment. Discharge does not automatically mean fitness to fly.

Arrange a neurosurgical review

Tell MPGCARE your age, main symptoms, duration, diagnosis, current treatment and review question. Before travel, confirm the receiving hospital/team, proposed service scope, interpreter, required visits, aftercare and physician-approved travel timing. The definitive clinical plan follows specialist assessment.

Contact: +90 850 259 5553

Medical information sources

AANS · NINDS · National Cancer Institute · NIDDK · Liv Hospital

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