常见问题

通常依肿瘤类型和位置在 2 至 8 小时之间；单纯的脑膜瘤切除可能为 2 至 3 小时，而深部或清醒下的胶质瘤手术可达 6 至 8 小时。时间本身并非成功的衡量标准；重要的是手术正确而彻底地完成。一般有 24 至 48 小时的重症监护和总计 3 至 7 天的住院。

不。对某些肿瘤手术是首选，但较小的无症状脑膜瘤可以随访，淋巴瘤以化疗-放疗而非手术治疗，某些深部胶质瘤可通过活检加放疗/伽玛刀来处理。正确的方法由组织学诊断和多学科评估决定。

不会。现代做法力求尽量少剃；多数情况下只沿切口线剃一窄条。如今很少需要剃光整个头部。

可以。患者来自土耳其各地及海外。您可通过 WhatsApp（+90 533 075 72 94）发送现有的核磁或 CT 影像以获得初步评估。如合适，将邀请您前来就诊，并在需要时安排进一步影像检查。

不会。大多数动脉瘤从不破裂，且未被察觉；在小动脉瘤（<7 毫米）中，年破裂风险相当低。风险随大小、部位、家族史和增长速度而变化，并用 PHASES 评分等工具来估算。

两者都是文献报告成功率为 90%–95% 的有效方法；「更好」的那个是最适合患者的那个。弹簧圈栓塞创伤较小、恢复快，但有再通（复发）风险；夹闭提供永久性解决方案，但需要开颅。决策根据动脉瘤特征和患者因素作出。

如果您出现数秒内骤起、为一生中最剧烈的头痛（感觉「脑中有东西爆裂」），并伴有颈强直、恶心-呕吐或意识模糊，请立即前往急诊并拨打急救电话。此种表现可能是破裂动脉瘤导致的蛛网膜下腔出血，早期治疗能挽救生命。

大多数动脉瘤并非遗传。但如果您有两位或以上一级亲属有动脉瘤或脑出血病史，家族风险会升高；此时可能建议用 MRA 进行筛查。您可通过 WhatsApp（+90 533 075 72 94）分享您的核磁/CT 影像以获得初步评估。

分流通过永久性的导管-阀门系统将多余的 CSF 引流至腹腔，通常终生保留。ETV 在脑室底部开孔，使机体自身的液体循环重新运作；不留异物。分流在交通性脑积水和 NPH 中更突出，ETV 在合适的梗阻性病例中更突出。方法依脑积水类型和患者来选择。

在大多数分流患者中，CSF 循环不会自行恢复，故该系统是永久性的。即便如此，绝大多数患者仍会重返学校、工作和日常生活；游泳、步行和骑自行车均适宜，仅不建议高冲击接触性运动和深潜。在 ETV 成功的病例中，可能无需分流。

NPH 是一种可治疗的病症，通过分流，相当比例的患者报告步态和认知功能显著改善；但不能保证每位患者都达到同等程度的成功。术前可做「放液试验」以预测成功几率。携带步态视频和近期核磁前来会使评估更为便利。

患者来自土耳其各地及海外。您可通过 WhatsApp（+90 533 075 72 94）发送现有的核磁影像（若怀疑 NPH，还可附上步态视频）。如合适，将邀请您前来就诊；如有需要，会安排 CSF 流动核磁和放液试验等进一步检查。

多数情况下不需要。体积小、无症状、生长缓慢的脑膜瘤可以间隔做核磁随访，尤其在老年人中。若肿瘤增大、引起不适或产生压迫，才考虑手术或伽玛刀。决定因个体而异，依肿瘤的大小、位置及随访中的表现而定。

绝大多数病例（约五分之四）为良性（1 级），并非传统意义上的癌症。较小一部分表现为不典型（2 级）或恶性（3 级）。真正的级别只有通过对切除组织的病理检查才能确认。

在部分患者中可以。对深部、手术风险高或经选择的中小型脑膜瘤，立体定向放射外科可能有效。但对大的、有症状或明显压迫的肿瘤，手术更为优先。合适的方法由核磁与多学科评估决定。

可以。患者来自土耳其各省。您可通过 WhatsApp（+90 533 075 72 94）发送现有的核磁或 CT 影像以做初步评估。若合适，将邀请您前来就诊，必要时安排进一步影像检查。

可切除大部分可见肿块，但由于胶质母细胞瘤在显微镜下向看似健康的组织扩展，单靠手术并不足够。因此术后会按标准进行放疗与化疗。切除的肿瘤比例越高，结果往往越有利，但「完全清除」对这一肿瘤并不现实。

标准方案是术后约 6 周放疗并同步口服替莫唑胺，随后进行维持期替莫唑胺（Stupp 方案）。在经选择的患者中可考虑 TTFields 等选项。方案依病理与分子结果由多学科会诊确定。

MGMT 是一种 DNA 修复基因。若该基因在肿瘤中被沉默（甲基化），预期可从替莫唑胺化疗中获得更大益处。该检测取自手术所得组织，可指导治疗选择与现实预期。

可以。患者来自土耳其各地及海外。您可通过 WhatsApp（+90 533 075 72 94）发送现有的核磁/CT 影像及任何病理报告以做初步评估。若合适，将邀请您前来就诊并进行多学科规划。

在多发转移瘤时，通常更优先的是立体定向放射外科（伽玛刀、射波刀）而非手术；一次治疗可瞄准多个病灶。手术更多用于单发或少数、较大且有症状的转移瘤，或需要组织诊断时。正确的选择依转移瘤的数目、大小、位置及全身疾病的状况而定。

伽玛刀（立体定向放射外科）仅向靶病灶给予聚焦高剂量，并在很大程度上保护周围健康脑组织，认知副作用较少。全脑放疗照射整个脑，在病变非常广泛时予以考虑，但因其对记忆与注意力的影响，如今使用更为谨慎。

这在多数情况下是晚期癌症的一部分，无法承诺有保证的「彻底治愈」。然而现代治疗能有效缓解症状、控制疾病，并在经选择的患者中实现长期控制。目标是管理疾病、维护生活质量；预期会针对每位患者单独而坦诚地沟通。

可以。患者来自土耳其各地及海外。您可通过 WhatsApp（+90 533 075 72 94）发送现有的核磁/CT 影像及任何 PET 与肿瘤科报告以做初步评估。若合适，将邀请您前来就诊并进行多学科规划。

这取决于肿瘤的分级。低级别星形细胞瘤进展缓慢，但并非完全「良性」，因为它可能随时间升级；高级别者具侵袭性且为恶性。真实的分级与行为只有通过对手术或活检所取组织的病理与分子检查才能明确。

多数情况下建议尽可能广泛而安全的手术，因为切除的肿瘤体积对癫痫控制与疾病走向均有有利影响。在经选择的极小、无症状病例中可考虑密切的核磁随访，但此决定依肿瘤的位置、生长趋势与分子特征由多学科作出。

IDH 基因状态决定星形细胞瘤的真正类型与总体走向。IDH 突变型星形细胞瘤通常进展更慢，归入不同的治疗组；IDH 野生型肿瘤行为类似胶质母细胞瘤。该检测取自手术所得组织，可决定治疗选择与现实预期。

可以。患者来自土耳其各地及海外。您可通过 WhatsApp（+90 533 075 72 94）发送现有的核磁/CT 影像及任何病理报告以做初步评估。若合适，将邀请您前来就诊并进行多学科规划。

少突胶质细胞瘤由 IDH 突变与称为 1p/19q 共缺失的遗传标记界定，这一特征使其归入对放化疗反应相对较好的一组。因此其走向往往比许多同级别的其他胶质瘤更有利。要揭示这一差异，遗传检测必不可少。

1p/19q 共缺失是真正少突胶质细胞瘤诊断不可或缺的条件，并能预测对治疗的反应。携带此遗传缺失的肿瘤从放疗与 PCV 化疗中获益更多。该检测取自手术所得组织，可决定治疗选择与现实预期。

发作是少突胶质细胞瘤最常见的首发症状，通常需要治疗其背后的肿瘤。多数情况下建议尽可能广泛而安全的手术；这对疾病走向与癫痫控制均有有利影响。在经选择的某些病例中可考虑密切随访，但此决定依肿瘤的分级、位置与遗传特征由多学科作出。

可以。患者来自土耳其各地及海外。您可通过 WhatsApp（+90 533 075 72 94）发送现有的核磁/CT 影像及任何病理报告以做初步评估。若合适，将邀请您前来就诊并进行多学科规划。

No. Most patients with epilepsy live seizure-free on medication and do not need surgery. Surgery is considered for patients whose seizures cannot be controlled despite two appropriate drugs (drug-resistant) and whose seizure focus can be safely identified. Whether you are a candidate is understood only after a comprehensive evaluation.

In some patient groups, especially mesial temporal sclerosis and single-lesion epilepsy, the chance of long-term seizure freedom is high. But this is not a guarantee; in multifocal or widespread epilepsy the goal is often not complete freedom but a meaningful reduction in seizure frequency. Expectations are shared with you individually after evaluation.

Medications are not stopped immediately after surgery. After a period of observed seizure freedom, the team may plan a gradual reduction; some patients continue a low dose. Any change in medication is always made under the supervision of a neurologist.

Yes. Patients reach us from across Turkey and abroad. You can send your existing MRI, EEG and any video-EEG reports via WhatsApp (+90 533 075 72 94) for a preliminary assessment. If appropriate, a comprehensive epilepsy surgery evaluation is planned.

Almost always medication first. Drugs such as carbamazepine/oxcarbazepine provide marked initial relief in most patients. Surgical and interventional methods come into play when medication is insufficient or its side effects cannot be tolerated. Starting directly with surgery is not appropriate except in exceptional situations.

MVD is an operation that directly eliminates the vascular compression causing the pain and provides the longest-lasting relief in suitable patients, but it is a procedure requiring general anaesthesia. Gamma Knife is an incision-free, single-session radiation treatment; it is less invasive but its effect begins later and the recurrence rate is higher. Which is appropriate is determined by age, general condition and MRI findings.

It can. No method guarantees lifelong, definitive freedom from pain. MVD has the lowest recurrence rate in suitable patients; Gamma Knife and percutaneous methods carry a higher chance of recurrence. If pain recurs, treatment can be repeated or a different method chosen.

Yes. Patients reach us from across Turkey and abroad. You can send your thin-slice (trigeminal-protocol) MRI images via WhatsApp (+90 533 075 72 94) for a preliminary assessment. If appropriate, you will be invited for an examination and further imaging planned if needed.

No. Vestibular schwannoma is almost always a benign (non-cancerous) tumour and does not spread to other parts of the body. Its danger comes from being able to press on the facial nerve, the hearing-balance nerve and the brainstem as it grows. Being benign makes it possible to avoid haste in treatment.

Not necessarily. In small, asymptomatic or mildly symptomatic tumours a 'wait and scan' approach is a valid strategy; the tumour is followed with MRI at set intervals. Many small tumours remain stable for years. However, follow-up must be regular; if the tumour begins to grow, Gamma Knife or surgery comes into play.

There is no single right answer; the choice depends on tumour size, growth rate, hearing status and age. In small-to-medium tumours Gamma Knife is a non-surgical option with a high chance of preserving hearing. In large tumours pressing on the brainstem, microsurgery is the priority. The decision is made individually.

Yes. Patients reach us from across Turkey and abroad. You can send your contrast-enhanced internal-auditory-canal (acoustic-protocol) MRI images and, if available, your audiometry (hearing test) result via WhatsApp (+90 533 075 72 94) for a preliminary assessment. If appropriate, you will be invited for an examination.

No. Almost all pituitary adenomas are benign and do not spread through the body. Their importance comes from being able to disrupt the body's balance by secreting hormones, or to press on the optic nerves as they grow. The word 'tumour' does not always mean malignant.

No. Prolactin-secreting adenomas (prolactinoma) in particular are mostly controlled with medication, without surgery — even when large. Surgery comes into play in other hormone-secreting tumours that do not respond to medication and in non-functional tumours causing visual loss. The right decision is made after the hormone profile and MRI are assessed together.

Mostly no. The modern standard is the transsphenoidal method, reached endoscopically through the nostrils; the skull is not opened, no external scar remains and recovery is shorter. Only in selected, very large or extensive tumours may different approaches be needed.

Yes. Patients reach us from across Turkey and abroad. You can send your pituitary-protocol MRI images, hormone blood tests and, if available, your visual-field test via WhatsApp (+90 533 075 72 94) for a preliminary assessment. If appropriate, you will be invited for an examination.

No. A cavernoma is a low-pressure, slow-flow tangle of vessels and, when it bleeds, usually causes a small, limited haemorrhage. An aneurysm is a balloon in a high-pressure artery and, when it ruptures, causes sudden, large and potentially fatal bleeding. The risk, follow-up and treatment of the two are entirely different.

Mostly no. Cavernomas that have never bled, cause no symptoms, and especially lie in a deep or critical region are generally followed with regular MRI, because the risk of surgery may exceed the lesion's bleeding risk. Surgery comes into play in cavernomas that re-bleed, cause drug-resistant seizures or produce progressive symptoms.

Generally no. Unlike an aneurysm, because cavernomas are low-pressure structures they are not suitable for endovascular (catheter) treatment. The treatment options are surveillance or removal by microsurgery; the role of Gamma Knife is limited and controversial and it is not routinely recommended.

Yes. Patients reach us from across Turkey and abroad. You can send your MRI images including the special sequences for cavernoma (gradient echo / SWI) via WhatsApp (+90 533 075 72 94) for a preliminary assessment. If appropriate, you will be invited for an examination and further imaging planned if needed.