The Hospital Experience:

Seeing a Neurosurgeon

This section deals with questions that a potential patient – or “candidate” for surgery – might reasonably (and probably should) put to his or her surgeon, before deciding whether or not to submit to what amounts to a major surgical operation on the brain. We have not given any answers to these questions because surgeons differ in their approach to surgery and what precise surgical manoeuvres they use. Equally importantly, individual patients differ as regards their internal anatomy and just what needs to be “put right”. Medical risk factors also have to be considered and discussed fully. So too do a person’s social and family circumstances, and emotional needs.

Doctor speaking with a patient, both wearing face masks.

Asking good questions

It is not uncommon for the Charity to be approached, for guidance, by people who do not feel entirely at ease with the outcome of a consultation with a hospital specialist. Patients are entitled to ask for a second opinion in such circumstances, although seeking multiple opinions may create more doubts and uncertainties, particularly if seemingly conflicting advice is offered. Before looking elsewhere, it might be reasonable for a patient to ask for another appointment with his or her specialist and then to ask some specific questions, particularly if surgery is being proposed. It is important to realise that not all Chiari malformations or syringomyelia cavities require surgery but that it may be advisable in some cases.  Furthermore, the indications in children can be different from those in adults. 

Examples of questions you can ask

The Ann Conroy Trust considers that patients can reasonably ask the following questions of their neurosurgeon. Indeed, these same questions could be asked of any surgeon proposing a surgical procedure of any type.

  • If surgery is proposed, what is the reason for this?
  • What is likely to happen to the patient, both in the short and longer term, if surgery is not carried out?
  • What does any proposed operation involve – a brief outline of the procedure and what post-operative care will be required.
  • What intra- or post-operative complications could develop, what would be their effect, and what is the rough numerical likelihood of any such occurring?
  • Are there any non-surgical treatments that could be used, how successful might these be and what are their risks?
  • What is their surgeon’s personal experience with this sort of surgery. It would also be acceptable to enquire as to whether or not an MDT discussion has been held about their, or their child’s case.

Most neurosurgeons with experience in treating Chiari would be quite happy to answer such questions.

Getting a second opinion?

If you still feel uncomfortable after asking these questions, you are entitled to seek a second opinion, particularly regarding such an important matter. The neurosurgeon may well be quite happy to make such a referral, but otherwise the GP should be approached with this request.

Undergoing surgery