When Should You See a Neurosurgeon? Baptist Health Experts Provide Guidance

For actor Michael J. Fox, it was a tumor on his spine. For hockey star Jack Eichel, a herniated disk in his neck. Singer Cheryl Crow was diagnosed with a brain tumor, and actress Emilia Clarke suffered from more than one brain aneurysm. Their health conditions, while very different, sent them to the same type of medical expert ― a neurosurgeon.

Brian Snelling, M.D., director of cerebrovascular and endovascular neurosurgery at Marcus Neuroscience Institute at Boca Raton Regional Hospital, a part of Baptist Health.

“Neurosurgeons treat diseases of the central and peripheral nervous system,” explains Brian Snelling, M.D., director of cerebrovascular and endovascular neurosurgery at Marcus Neuroscience Institute at Boca Raton Regional Hospital, a part of Baptist Health. “This includes not only the surgical treatment disorders of the brain, but also includes the spine and peripheral nerves.”

Every August, the American Association of Neurological Surgeons observes Neurosurgery Awareness Month, educating the public on traumatic brain injuries, back pain, stroke, movement disorders such as epilepsy and Parkinson’s disease and other conditions that may send them to a specialist.

With 1.2 million spinal surgeries performed in the U.S. each year, 795,000 Americans suffering a stroke annually and some 1.4 million experiencing a head injury, according to the latest government statistics, neurosurgeons are in high demand. Those figures don’t even include the myriad of other health problems that wind up in a neurosurgeon’s office.

“While I primarily treat spine problems ― anything from the neck to lower back pain, including scoliosis ― neurosurgeons also treat brain tumors and aneurysms, stroke and other cerebrovascular problems and other conditions,” says Raul Vasquez, M.D., director of complex spine surgery at Baptist Health Miami Neuroscience Institute.

Raul Vasquez, M.D., director of complex spine surgery at Baptist Health Miami Neuroscience Institute.

Patients need to understand, however, that not every problem requires surgery, the physicians say. Many back problems can be solved ― or avoided ― through exercise, weight loss, smoking cessation and a healthy lifestyle, says Dr. Vasquez. In fact, the doctor regarded as the father of modern neurological surgery, Dr. Harvey Cushing, was one of the first to make the connection between smoking and vascular disease when he noted that the circulation in his lower legs improved dramatically after he stopped smoking.

“The vast majority of patients that I encounter do not need surgery,” Dr. Snelling says, adding that he understands the fears that often come with a visit to a neurosurgeon. “I am aware of the anxiety and uncertainty that comes with a surgical consultation. We strive to mitigate those concerns and treat patients as if they are family.”

When an injury does occur, it can sometimes be difficult for a patient to know when to seek help, the doctors agree. Any signs of stroke, such as weakness in the face, arm or leg, confusion or trouble speaking, vision problems, or severe headache, should prompt an immediate call to 9-1-1. Evidence shows that faster treatment results in better outcomes. “When in doubt, it’s best to visit the emergency department as opposed to waiting for an appointment,” Dr. Snelling says.

Those with neck, back, arm or leg pain, especially with numbness or tingling, should see a neurosurgeon, advises Dr. Vasquez. “But if they have symptoms such as being unable to urinate, have urinary incontinence, or have persistent and worsening back, leg or arm pain, they should go to the ER.”

Many neurosurgeons have subspecialty training in specific disciplines within neurosurgery. “As a dual-trained cerebrovascular neurosurgeon, my main area of expertise is in the surgical and endovascular treatment of blood vessel disorders of the brain and spine,” Dr. Snelling says. “This includes patients with ischemic stroke, brain aneurysms, brain AVMs (arteriovenous malformations), carotid artery disease and intracranial hemorrhages.”

If surgery is necessary, minimally invasive approaches are used whenever possible. With improvements in imaging and robotics, advances in navigation systems and brain mapping, and the increasing integration of artificial intelligence (AI) into the field, the surgeons agree that there is reason to be optimistic.

The neurosurgeons at Baptist Health also work closely with other specialists, including oncologists and neuro-oncologists, interventional and pain management specialists, otolaryngologists, plastic surgeons, physiatrists and neurologists, to name a few.

Baptist Health Brain & Spine Care is also leading and participating in a number of clinical research trials and studies to improve patient outcomes and advance the field of neuroscience. For a current list of studies, click here.

In the U.S. News & World Report 2023-2024 hospital rankings recently released, Miami Neuroscience Institute is ranked number 39 in the country for treating complex neurology and neurosurgery cases. Both Miami Neuroscience Institute and Marcus Neuroscience Institute are recognized for clinical excellence in stroke care.