Dr. V P Singh

Consultant neurosurgeon, operating on the brain, spine and nervous system — tumours, haemorrhage, hydrocephalus and compression of the spinal cord or nerve roots. These decisions are made from imaging, so a current MRI or CT is the single most useful thing to bring. The consultation covers what the surgery is intended to achieve and what it cannot.

What a neurosurgeon treats

Tumours of the brain and spine, haemorrhage, hydrocephalus, compression of the spinal cord or nerve roots, and some disorders of movement and pain. Modern practice leans heavily on intraoperative navigation and monitoring, and on removing as much as can be removed safely rather than as much as possible.

When you would be referred

An abnormal brain or spine scan, seizures of new onset, persistent and changing headache with neurological signs, or weakness and numbness that follow a spinal cord or nerve root pattern. Sudden severe headache, sudden weakness or a rapid drop in consciousness are emergencies, not referrals.

At the first consultation

These decisions are made from imaging, so the scan is the centre of the appointment. Expect the site of the problem, the intended approach, and the trade-off between how much is removed and what function is at risk to be set out explicitly. Where a tumour sits near speech or movement areas, monitoring during surgery — or an awake craniotomy — may be proposed, and it should be explained rather than announced.

What to bring, and what to ask

A current MRI or CT on disc, previous scans for comparison, and any histology from an earlier biopsy. Worth asking: what is this operation intended to achieve, what will it not achieve, what is the realistic risk to speech or movement, and what happens after the tissue goes to the laboratory.