General adult neurosurgical conditions

Brain metastases

Tumours that have spread to the brain from cancer elsewhere in the body, such as the lung, breast, kidney or skin (melanoma). Treatment is planned with your oncology team and depends on the number, size and position of the metastases and on your overall health. Options include surgery to remove a metastasis, particularly a larger one causing symptoms or when a diagnosis is needed; Gamma Knife radiosurgery, a focused single-session radiation treatment without an incision, for selected metastases or after surgery; whole-brain radiotherapy; and medical cancer treatments.

Chronic subdural haematoma

A collection of old blood on the surface of the brain, most often in older adults and people taking blood thinners, sometimes after a minor head injury. It can cause headaches, confusion, weakness or unsteadiness. Small collections may be watched; larger or symptomatic ones are usually drained through small burr holes.

Head injury

Most head injuries are minor. Neurosurgical care is needed for skull fractures, bleeding around or within the brain, or raised pressure. Anyone who is drowsy, confused, vomiting repeatedly, has a seizure or is on blood thinners after a head injury needs urgent assessment.

Trigeminal neuralgia

Brief, severe, electric-shock-like facial pain, often triggered by touch, eating or talking. Medication (such as carbamazepine) is the first treatment. When medication fails or causes side effects, Gamma Knife radiosurgery is an option; other procedures, such as microvascular decompression or percutaneous treatments, may be discussed with you individually.

Brain abscess and infections

Infections of the brain or its coverings, including brain abscess and parasitic infections such as neurocysticercosis and, rarely, coenurosis. Treatment combines medication (antibiotics or antiparasitic drugs) with surgery to drain an abscess or relieve pressure or hydrocephalus when needed, together with the infectious diseases team.

Dr Labuschagne's publications on this topic

• Labuschagne J, Frean J, Parbhoo K, et al. Disseminated human subarachnoid coenurosis. Trop Med Infect Dis. 2022;7(12):405.
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Chiari malformation in adults

The lowest part of the back of the brain sits lower than usual, through the opening at the base of the skull. Many people have no symptoms. Typical symptoms are headaches at the back of the head brought on by coughing or straining, and sometimes a fluid cavity in the spinal cord (syrinx). Surgery (posterior fossa decompression) is considered for typical symptoms or a syrinx.

Arachnoid cysts

Fluid-filled sacs within the membranes covering the brain or spine. Most are found by chance and need no treatment. A small number cause symptoms through pressure and may be treated endoscopically or with surgery.

Cavernoma

A cluster of abnormal small blood vessels (cavernous malformation) in the brain or spinal cord. Many cause no symptoms; some cause seizures or bleeding. Options include monitoring with MRI scans or surgical removal, depending on position and symptoms.

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