Patients suffering from a brain tumor or other disorder of the central nervous system may become frustrated by differing medical opinions on the treatment plan for their condition. In the end, the decision to proceed with surgery is up to the patient after he or she has secured an objective opinion about the treatment options. Here, I discuss possible factors that can influence whether neurosurgery is right for you and, if so, how to determine with which neurosurgeon to proceed.

對大腦進行手術有輕度到中度的長期並發症風險，尤其是當腫瘤位於外科醫生難以通過手術到達的關鍵區域時。盡管手術後病情惡化的幾率很低，但在某些情況下，手術可能會變得太危險，因此應尋求其他治療方案，如放射治療。外科醫生應該非常熟悉所有的選擇和方法offer these options to the patient objectively.外科醫生對合理平等的治療方案的偏好不應成為最終因素。

神經外科醫生在確定手術是否合適時經常考慮以下信息。

在手術過程中,外科醫生必須首先到達the tumor with surgical instruments and then remove as much of it as safely possible. This procedure poses the least risk to the patient when a tumor is easy to reach and visualize, isolated from critical structures, and immediately differentiable from the brain and does not stick to surrounding structures.

• 位置和可達性: Tumors in areas that are difficult to reach surgically (for example, deeper in the brain or at the skull base) may require extensive manipulation of brain tissues and surrounding structures. Once reached, the tumor still might be difficult to visualize and remove completely, which can allow the tumor to grow back.這類腫瘤的手術需要特殊的專業知識。
• 接近關鍵結構: Tumors near or infiltrating specific areas of the brain that control critical functions such as movement, speech, sensation, and vision (“eloquent areas”) increase the risk of functional impairment after the procedure.
• 大小: In some cases, smaller lesions of the brain can be treated with radiation therapy or other treatments alone. In other rare cases, radiation can be used to reduce the size of a larger lesion before surgery.
• Type:一些腫瘤生長非常緩慢。在這些病例中，觀察、聚焦放射（放射外科）或其他治療方法可能足以替代手術。必須強調的是，隨著時間的推移，可能隻會觀察到不產生症狀的生長緩慢的小腫瘤。僅僅因為你有一個偶然的小腫瘤並不意味著你需要手術。

接受手術的患者必須能夠在身體上耐受手術和恢複過程，這可能包括物理治療以恢複最大功能。如果偶然發現腫瘤，且患者沒有任何症狀，則可能不需要治療。觀察可能是老年患者良性和緩慢生長腫瘤的首選選擇。這類患者可能會定期進行磁共振成像（MRI），以確保腫瘤不會生長。

Choosing the right neurosurgeon for your procedure is critical. Patient reviews and hospital and/or institute reputation for a specific condition can be taken into consideration, but they should not be the final deciding factors.神經外科醫生的決定取決於其他多種因素。雖然沒有確定患者應該信任的神經外科醫生的標準，但我們鼓勵考慮以下幾點：

• Specialized Experience：根據與其他醫生的討論，找一位在治療你的疾病方麵有豐富經驗的神經外科醫生。最好的醫院可能不會為你提供最好的外科醫生。詢問神經外科醫生是否在你的外科專業（例如顱底腫瘤）接受過額外培訓，如獎學金。盡管外科醫生在這個問題上進行的大量研究可能很重要，但了解接受他們護理的患者的臨床數量尤其重要。
• Honesty and Integrity: Patients need to find a neurosurgeon who prioritizes the patient’s best interest, is willing to discuss all possible treatment options, and is completely honest about his or her own surgical experience with a condition. Such surgeons may offer valuable referrals to a colleague with more knowledge on the specific condition or surgical approach. Open communication is critical for the patient to decide on the best possible path of treatment and know what to expect.
• 繼續教育：神經外科是一個動態的領域，隨著新的研究、手術技術和治療方式的不斷更新。找一位神經外科醫生，他能充分了解該領域的進展，並能為你提供該領域目前所能提供的最佳服務。與你的外科醫生討論當前治療方案的風險和益處。

獲得第二和第三種意見是找到最佳治療方案的關鍵途徑。

尋求正確的治療方案和神經外科醫生來診斷腦腫瘤或任何其他中樞神經係統病變可能是一個極具挑戰性的旅程。探索我們的其他章節，了解更多關於你的病情，閱讀啟發患者的故事，了解在安全有效的手術後，生命如何繼續。