Frequently asked questions about neurosurgery

Call (664) 104-9153 or (664) 375-4216, write to info@neurocirujanotijuana.com, or use the form on this page. The office is at Del Prado Medical Tower, floor 17, suite 1705, C. Bugambilias 4083, Fraccionamiento El Prado, Tijuana. Consultation hours are Monday to Saturday, 9:00 AM to 7:00 PM.

Your complete imaging — MRI, CT, angiography or plain radiographs — on disc, USB or film, together with the radiologist's report. Also bring your current medication list, recent laboratory results and any summaries of previous consultations or operations. Without the original images, the visit can only go halfway.

Yes. Neurosurgical emergencies are attended 24 hours a day, 7 days a week. If there is loss of consciousness, projectile vomiting, sudden weakness on one side, difficulty speaking, a seizure, or the worst headache of your life, do not wait for an appointment: go to the nearest emergency department and call. Never email an emergency.

No. Most lumbar disc herniations improve with conservative treatment within six to twelve weeks. Surgery is indicated when there is progressive neurological deficit, cauda equina syndrome — an immediate emergency — or disabling radicular pain that has not settled with properly delivered treatment. An MRI showing a herniation is not, on its own, an indication to operate.

Yes, and it is a good idea. Bring the imaging and the surgical plan you were given. The visit reviews whether the indication holds, whether less invasive alternatives exist, and what waiting would gain or cost you. No serious colleague is offended by a second opinion.

Yes. Consultations run in Spanish or English and the office is minutes from the border crossing. Clinical reports and operative summaries are issued in whichever language your physician in the United States needs to read. Note that most US insurers do not cover care in Mexico — confirm with your carrier before scheduling.

A neurologist diagnoses and treats nervous system disease with medication; a neurosurgeon treats it when an operating room and a procedure are required. Many patients need both, and in several conditions — epilepsy, brain tumour, hydrocephalus — treatment is decided jointly.

The cost of the consultation and of any procedure depends on the case and the hospital, and you are told before anything is scheduled. Call the office for the current first-visit fee and to confirm whether your major medical policy is in network.

It depends on the procedure. A lumbar microdiscectomy usually allows walking the same day and a return to desk work in two to four weeks; a multi-level instrumented fusion needs three to six months to consolidate. At your visit you get the timeline for your case, not the average from a brochure.

Yes. Congenital hydrocephalus, myelomeningocele, craniosynostosis, cranial deformities and nervous system tumours in childhood are part of the practice. In paediatrics the consultation is explained twice: once for the chart and once for the parents.

It is very unlikely. The overwhelming majority of headaches are migraine or tension-type, not tumours. What is concerning is a headache that is new and different from your usual one, wakes you at night, worsens on coughing or bending, or comes with vomiting, seizure, double vision or weakness. That combination does warrant imaging.

The great majority are not. Rare genetic syndromes such as neurofibromatosis or Li-Fraumeni raise the risk, but they account for a small fraction of cases.

Large epidemiological studies have not demonstrated that link. Research continues, but there is no solid evidence supporting that cause today.

It depends on the tumour. A small meningioma can be watched for years; a tumour with oedema and mass effect cannot. At your visit you are told explicitly whether your case allows time for a second opinion or whether action is needed soon.

Not necessarily. Disc herniations appear even on scans of people with no pain at all. What decides surgery is symptoms, neurological examination and imaging agreeing on the same level and side, plus failure of properly delivered conservative treatment.

It is massive compression of the roots at the end of the spinal cord. It presents with difficulty or inability to pass urine, incontinence, saddle numbness and weakness in both legs. It is a surgical emergency: go to an emergency department immediately, do not wait for an appointment.

Yes, and in fact prolonged rest makes things worse. What needs adjusting is the type: walking, swimming and guided trunk strengthening, yes; lifting weight from the floor with a flexed spine, no. A physiotherapist should guide the progression.

They can give temporary relief and help you through the acute phase while the herniation reabsorbs, particularly in severe radicular pain. They do not correct the compression definitively, so they are used as part of conservative treatment, not as a substitute for a clear surgical indication.

The worrying pattern is thunderclap headache: absolutely sudden onset, maximum intensity within seconds, unlike any previous pain, often with vomiting and neck stiffness. If that happens, go to an emergency department immediately — it is not a picture to wait out at home.

Screening is recommended mainly when two or more first-degree relatives are affected, or in certain conditions such as polycystic kidney disease. With a single affected relative the indication is discussed case by case. Ask before ordering studies on your own.

Many are followed with periodic CT angiography while blood pressure is controlled strictly and smoking stopped — the two measures that most reduce risk. Treatment follows when size, irregular shape or growth justify it.

There is no guarantee, but controlling hypertension and giving up tobacco significantly reduce risk. They are the two best-supported recommendations for anyone living with a known aneurysm.

It is not cured in the sense of disappearing, but it is very well controlled. A shunt diverts the fluid permanently and allows a normal life. In some obstructive cases, endoscopic ventriculostomy restores circulation without implanting hardware.

The signs are the return of what was there before: headache, vomiting, drowsiness, irritability, changes in gaze or seizures. Also redness or swelling over the catheter track and fever. With any of these, seek care the same day.

It could be normal-pressure hydrocephalus, which is treatable. It deserves imaging and a neurosurgical assessment before assuming irreversible dementia. Here the right diagnosis changes the outcome.

Yes. Most activities, sport included, are possible. Only contact sports with a risk of direct impact over the catheter track are discouraged, and that is decided individually.

If he did not lose consciousness, has not vomited, is not drowsy or confused and is behaving normally, watching him at home for 24 hours is usually enough. Go to the emergency department if repeated vomiting, unusual drowsiness, increasing headache, a seizure or any behavioural change appears.

Yes, considerably. In anticoagulated patients an apparently minor blow can produce intracranial bleeding that shows up hours or days later. In that case CT and observation are advisable even without initial symptoms.

It is a transient disturbance of brain function after a blow, with no visible lesion on CT. There may be confusion, headache, dizziness, nausea, difficulty concentrating and light sensitivity for days or weeks. It calls for graded cognitive and physical rest, and avoiding a second impact while it lasts.

Yes. After moderate trauma, problems with memory, attention, irritability and fatigue are common and do not always show on imaging. They deserve assessment and neurological rehabilitation rather than being dismissed.

In mild and moderate cases, often yes: flexion-based physiotherapy, weight control, walking with support and, in some patients, injections. Surgery is considered when the distance you can walk limits your life, or when weakness appears.

Because flexing the spine gains the canal a few millimetres of diameter and root compression eases. It is a mechanical phenomenon, and it is the clue that separates stenosis from other causes of pain on walking.

No. A herniation usually compresses a single root and causes pain in one leg, often in younger people. Stenosis compresses several roots, usually affects both legs, and comes from wear, typically after sixty.

It can be very much worth it, because what is regained is the independence to walk. What is assessed is not age on paper but cardiovascular, pulmonary and functional status. Decompression without instrumentation is well tolerated by many older patients.

Dental pain is usually continuous and throbbing, worsens with heat or cold applied to the tooth, and responds to analgesics. Trigeminal neuralgia gives bursts lasting seconds with pain-free intervals, is triggered by touching the face or speaking, and responds poorly to ordinary painkillers.

It does not threaten life, but it can be profoundly disabling: some patients stop eating, speaking or going out for fear of an attack. That effect on daily life is reason enough to treat it seriously.

No. Most patients respond initially to carbamazepine or oxcarbazepine. Surgery enters when the medication stops working, when the dose must rise to intolerable levels, or when side effects prevent continuing.

Yes. When neuralgia appears in a young person, or affects both sides, multiple sclerosis and compressive lesions should be excluded with MRI. That is one reason imaging is not skipped.

A chronic subdural haematoma usually declares itself two to eight weeks after the injury, sometimes longer. That delay is exactly what causes it to be missed: by the time symptoms appear, nobody connects them to the knock.

Draining a chronic haematoma is among the least invasive neurosurgical procedures: one or two small holes, sometimes under local anaesthesia, a closed drain and a short hospital stay. The acute traumatic form is a major, urgent craniotomy.

They will need to be stopped temporarily around surgery and restarted afterwards with judgement, in coordination with cardiology or internal medicine. The decision weighs bleeding risk against thrombosis risk, and it is made jointly.

It can recur, particularly in patients with marked cerebral atrophy or those restarting anticoagulation. That is why a closed drain is left, CT follow-up is done and the patient is watched over the following weeks.

Isolated mechanical neck pain without arm or hand symptoms is usually managed first with physiotherapy, postural care and analgesia. MRI is indicated when there is arm-radiating pain, a neurological deficit, signs of myelopathy, or failure of treatment.

They matter for comfort and can aggravate or ease mechanical pain, but they neither cause nor cure a cervical herniation. Looking for a comfortable sleeping position is reasonable; expecting a pillow to resolve root compression is not.

If tingling wakes you in the early hours, affects thumb, index and middle fingers and improves on shaking the hand, it points to the carpal tunnel. If pain runs from the neck down the whole arm and changes with neck movement, it points to the cervical spine. Examination and electromyography clarify it.

It can be a sign of cervical myelopathy — spinal cord compression — and should be assessed promptly. That symptom, along with an unsteady gait, is not one to wait out.

Seek medical assessment. A first seizure in adulthood requires investigating the cause with history, electroencephalogram, blood tests and MRI, precisely to exclude a treatable structural lesion. Do not assume it was stress or tiredness without investigation.

No — in fact it is a minority. Most is well controlled with medication. Surgery is reserved for patients with focal seizures unresponsive to two or more drugs, in whom the work-up identifies a resectable focus with acceptable functional risk.

They often improve substantially, particularly when the lesion was clearly responsible. They do not always disappear entirely or allow anti-epileptic medication to be stopped straight away: neurology decides that over time with follow-up EEGs.

Protect them from injury, move hard objects away, turn them on their side, put nothing in their mouth, and time it. If the seizure lasts more than five minutes, repeats without them regaining consciousness, or is the first ever, call emergency services.