Pyetjet e Shpeshta

Depending on the type and location of the tumor, it usually ranges between 2 and 8 hours; a straightforward meningioma removal may be completed in 2–3 hours, while a deep-seated or awake glioma operation can take 6–8 hours. A shorter duration does not mean greater success. After surgery, 24–48 hours in intensive care and a total hospital stay of 3–7 days are usual.

No. In some tumors surgery is the first option, but a small, asymptomatic meningioma may simply be monitored, lymphoma is treated with chemotherapy-radiotherapy rather than the scalpel, and in some deep-seated gliomas biopsy and Gamma Knife come to the fore. The right path is determined by tissue diagnosis and team assessment.

No. Today’s approach relies on shaving as little as possible; in most cases a thin strip shaved along the incision line is enough. Shaving the entire head is now rarely necessary.

Yes. You can send the MRI or CT images you have from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination, and additional imaging will be planned if needed.

No. The great majority of aneurysms never rupture and remain unnoticed; the annual rupture probability is quite low in sacs under 7 mm. Risk varies with size, location, family history and growth rate, and is estimated with tools such as the PHASES score.

Both are effective methods reporting 90–95% success in the literature; the ‘better’ one is the one best suited to that patient. Coiling is less invasive and recovers quickly but carries a risk of reopening; clipping offers a permanent solution but requires opening the skull. The decision is made according to the aneurysm’s features and patient factors.

If you have the worst headache of your life that bursts within seconds (a feeling that ‘something snapped in my head’) together with neck stiffness, nausea-vomiting or clouded consciousness, go to the emergency department without losing time and call the emergency number. This picture may be a subarachnoid haemorrhage due to a ruptured aneurysm.

Most aneurysms are not hereditary. However, if two or more first-degree relatives have a history of aneurysm or brain haemorrhage, the familial risk rises; in that case screening with MRA may be recommended. You can obtain a preliminary assessment by sharing your MRI/CT images from Istanbul via phone or WhatsApp (+90 533 075 72 94).

A shunt transfers the excess CSF to the abdominal cavity with a permanent tube-valve device and usually stays for life. ETV, by opening a hole in the floor of the ventricle, makes the body’s own fluid circulation work again; it leaves no foreign body behind. The shunt comes to the fore in communicating hydrocephalus and NPH, ETV in suitable obstructive cases. The method is chosen according to the type of hydrocephalus and the patient.

In most patients fitted with a shunt, because the CSF circulation does not correct itself, the system is permanent. Nonetheless, the great majority of patients return to school, work and daily life; swimming, walking and cycling are appropriate, only high-impact contact sports and deep diving are not recommended. In cases where ETV is successful, a shunt may not be needed.

NPH is a treatable condition, and with a shunt a significant proportion of patients are reported to have meaningful improvement in walking and cognitive function; however, the same degree of success cannot be guaranteed in every patient. To predict the chance of success, a ‘tap test’ can be performed before surgery. Applying with a walking video and a recent MRI makes the assessment easier.

You can send the MRI images you have (and, if NPH is suspected, additionally a walking video) from Istanbul via phone or WhatsApp (+90 533 075 72 94). If appropriate, you will be invited for an examination; if needed, additional imaging such as a CSF-flow MRI and a tap test will be planned.

Often no. A small, asymptomatic, slow-growing meningioma can be observed with periodic MRI, especially in older patients. If the tumor grows, causes symptoms or compresses, surgery or Gamma Knife comes into consideration. The decision is made individually according to the tumor's size, location and behavior on follow-up.

The large majority of cases (about 80-85%) are benign (WHO grade 1) and are not cancer in the classic sense. A smaller proportion behave atypically (grade 2) or malignantly (grade 3). The true grade of the tumor becomes clear only with pathological examination of tissue obtained at surgery.

In some patients, yes. For deep-seated, surgically high-risk or small-to-moderate meningiomas, stereotactic radiosurgery (Gamma Knife, CyberKnife) is an effective option. However, for large, symptomatic or compressing tumors, surgery comes to the fore. Which method is appropriate is determined by MRI and multidisciplinary evaluation.

Yes. You can send the MRI or CT images you have from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination in Istanbul, and additional imaging will be planned if needed.

Because glioblastoma infiltrates the surrounding brain microscopically, surgery alone does not provide a 'cure'; for this reason radiotherapy and chemotherapy (the Stupp protocol) follow the operation. The aim of treatment is to control the disease and preserve quality of life. No outcome can be guaranteed, and expectations are shared honestly.

Because glioblastoma grows rapidly, treatment is usually planned quickly. Once the diagnosis is clear, surgery and then the radiotherapy-chemotherapy course are started without delay. How long to wait is determined by the tumor's location, the patient's condition and multidisciplinary evaluation.

The goal is the widest possible safe resection while preserving function. If the tumor is close to critical areas such as speech or movement, the resection may be kept limited to reduce the risk of permanent loss. The microscopic disease that cannot be removed is targeted with radiotherapy and chemotherapy.

Yes. You can send the MRI or CT images you have from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination in Istanbul, and additional imaging and multidisciplinary evaluation will be planned if needed.

Either may be right depending on the situation. For a single, large, symptomatic lesion, surgery comes to the fore; for small-to-moderate or a few lesions, Gamma Knife (stereotactic radiosurgery) is preferred. For more than five widespread metastases, Gamma Knife or whole-brain radiotherapy comes into consideration. The decision is made multidisciplinarily according to the number, size and location of metastases and the primary cancer.

Imaging gives strong clues but is not always certain. Even with a known cancer, a brain mass can sometimes be a separate tumor (for example, a meningioma). For a single lesion, surgical resection both provides treatment and clarifies the tissue diagnosis; for this reason pathology is important for differential diagnosis.

Yes. Even with multiple metastases, there are options including Gamma Knife, whole-brain radiotherapy and systemic treatment targeting the primary cancer (targeted drugs, immunotherapy). Outcomes vary with the type and molecular features of the primary cancer; long-term control is possible in some patients. The plan is built individually with the multidisciplinary team.

Yes. You can send your existing MRI or CT images and, if available, your primary cancer information via WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination in Istanbul, and additional imaging and multidisciplinary evaluation will be planned if needed.

No. With the 2021 WHO classification, IDH-mutant astrocytoma and IDH-wildtype glioblastoma are considered distinct diseases. IDH-mutant astrocytomas carry a markedly better prognosis. The true type and grade of the tumor become clear with pathological and molecular examination of tissue obtained at surgery or biopsy.

The decision is made according to the tumor's grade, IDH status, location and size. While close surveillance after surgery is possible in some low-grade tumors, the widest safe resection is the first step in most cases. The correct path is determined by tissue diagnosis and multidisciplinary evaluation.

The goal is the widest possible resection while preserving function. If the tumor is close to critical areas such as speech or movement, functional mapping and, when needed, awake craniotomy are used, and the resection margin is set accordingly to reduce the risk of permanent loss. The risks are discussed openly before surgery.

Yes. You can send your existing MRI or CT images and, if available, your pathology-molecular results via WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination in Istanbul, and additional imaging will be planned if needed.

Tissue is required for a definitive diagnosis: under the 2021 WHO classification, both an IDH mutation and 1p/19q co-deletion must be demonstrated. This tissue is obtained by surgical resection or stereotactic biopsy. In most cases, the widest safe resection provides both treatment and an accurate molecular diagnosis.

Oligodendroglioma has the most favorable prognosis among diffuse gliomas and is sensitive to radiotherapy-chemotherapy, but because it is a diffuse tumor it is not correct to call it 'benign'. Prognosis varies with grade, extent of resection and molecular features; close follow-up is recommended. No outcome can be guaranteed.

It could. Because of its cortical location, oligodendroglioma can run for a long period with epilepsy as the sole symptom. Seeing a cortical-subcortical, often calcified lesion on MRI raises suspicion; the definitive diagnosis is made by tissue and molecular examination. You can send your existing MRI for us to assess.

Yes. You can send your existing MRI or CT images and, if available, your pathology-molecular results via WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination in Istanbul, and additional imaging will be planned if needed.

Not directly. First the diagnosis of drug-resistant epilepsy must be confirmed and the seizure focus clearly mapped. This requires video-EEG monitoring, epilepsy-protocol MRI and neuropsychological testing. Surgery becomes an option only if all of this data points to a single focus that can be safely removed.

Not immediately. Medications continue for a period after surgery; only after a seizure-free observation period can a gradual reduction be planned, and only under your neurologist’s supervision. Some patients continue low-dose treatment. This decision is entirely individual.

This risk depends on the location of the focus, which is exactly why pre-operative neuropsychological tests and functional mapping are performed. For foci adjacent to speech or movement areas, awake surgery is used when needed. Possible effects are explained to you openly and individually before surgery in every case.

Yes. You can send the MRI, EEG reports and your medication history you have from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for detailed monitoring and testing.

No. Treatment almost always begins with medication; nerve-pain drugs such as carbamazepine provide marked relief in many patients. Surgery comes to the fore when medication is inadequate, when side effects become intolerable, or when the patient does not want to remain dependent on medication.

This choice depends on your age, general health, MRI findings and expectations. Microvascular decompression addresses the cause and can give the most lasting result in suitable patients; Gamma Knife and percutaneous procedures are less invasive and come to the fore with older age or other illnesses but may leave facial numbness. The right choice is individual.

This depends on the method chosen. With microvascular decompression the risk of facial numbness is generally low; with percutaneous procedures and radiosurgery, facial numbness can be more common. Possible effects are explained to you openly and individually before the procedure.

Yes. You can send your thin-slice MRI and pain history from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination, and additional imaging to clarify the vessel–nerve relationship will be planned if needed.

No. Acoustic neuroma (vestibular schwannoma) is almost always a benign, slow-growing tumor that does not spread to other organs. Even so, because of its location it can affect hearing, balance and the facial nerve, so it requires follow-up and, where appropriate, treatment.

No. For small, asymptomatic tumors — especially in older patients — observation (wait-and-see) with regular MRI is often the right option, because some of these tumors do not grow significantly for years. Surgery or radiosurgery comes to the fore when growth or increasing symptoms occur.

This depends on the tumor’s size, location and your pre-operative hearing level. Continuous nerve monitoring is used during surgery to protect the facial nerve. Hearing can be preserved in some cases and not in others; these possibilities are explained to you openly and individually before surgery.

Yes. You can send your hearing test (audiometry) and thin-slice MRI results from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination, and additional imaging will be planned if needed.

No. A prolactinoma is most often treated with medication (dopamine agonists) and can shrink; small, non-secreting and asymptomatic adenomas can be followed with regular MRI. Surgery comes to the fore especially in large tumors threatening vision and in growth-hormone or ACTH-secreting tumors. The decision is made according to the tumor type.

In most cases the operation is done through the nose (endoscopic transsphenoidal); the skull is not opened, the brain is not retracted, and no incision scar is left on the face or head. This method is far less invasive than open surgery. Only in selected, very large or differently located tumors may another approach be needed.

Not always; this depends on the tumor’s type, size and how much the pituitary is affected. In some patients hormone levels return to normal, while others may need hormone support under an endocrinologist’s supervision for permanent deficiencies. This becomes clear with post-operative testing.

Yes. You can send your hormone blood tests, pituitary MRI and any visual-field results from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination; the process is planned together with endocrinology where needed.

Most often, no. For cavernomas that are asymptomatic, have not bled before and are located in a deep/critical region, the most common decision is observation with regular MRI, because the annual bleeding risk is generally low. Surgery comes to the fore in situations such as recurrent bleeding, resistant seizures or progressive symptoms.

No. A cavernoma is a low-pressure, slow-flow structure; its bleeding is usually not sudden and devastating as in an aneurysm but more limited and slow. For this reason most cavernomas are not an emergency, though they still need to be assessed according to their location.

It can, but only in very carefully selected situations. The brainstem is a critical region; the decision to operate there is made by carefully weighing the expected benefit against the possible risk, when there is a strong justification such as recurrent bleeding or progressive symptoms. In some cases observation may be safer.

Yes. You can send your MRI images (preferably ones including gradient echo / SWI sequences) and your symptom history from Istanbul via phone or WhatsApp (+90 533 075 72 94) and receive a preliminary assessment. If appropriate, you will be invited for an examination, and additional imaging will be planned if needed.