Headache: This is one of the most common symptoms in neurosurgery. In fact, most of the headaches in daily life are functional and there is no organic lesion of the brain, only the following cases should be promptly seen in neurosurgery.
(1) Acute attack of headache. (1) Acute attacks of headache. Patients who usually have no headache symptoms suddenly have severe headache and even vomiting, which can be seen in intracranial hemorrhage, acute inflammation, tumor stroke, etc;
(2) Recurrent paroxysmal headache. It is usually seen in vascular headache, epileptic headache, occipital neuralgia, or cervical spondylosis, etc;
(3) Gradually worsening headache. If there is a gradual loss of vision when the headache is aggravated, and if the headache is accompanied by jet vomiting, it is a typical “three main signs” of cranial hypertension, mostly due to neurosurgical diseases.
Facial pain: including pain in the face, eyes, nose, mouth and teeth.
(1) If there is a sudden onset of transient and severe pain on one side of the face, which feels like cutting, electric shock, burning or pins and needles, and it is easy to appear suddenly when washing face, brushing teeth, eating or talking, then we should consider the possibility of trigeminal neuralgia. It is especially important to point out that trigeminal neuralgia sometimes manifests itself as unbearable toothache. Patients often go to dentistry first and impatiently ask for tooth extraction, and as a result, half of the big teeth are often extracted and the pain is still not relieved in the slightest before they finally go to neurosurgery.
(2) If there is persistent vague, dull or swelling pain in the face without obvious intervals, the lesion around the trigeminal nerve should be considered and a neurosurgical consultation should be made.
(3) If there is a transient severe pain at the root of the tongue, deep in the mouth, or deep in the external auditory canal, and the pain is often induced when swallowing, it may be a hyohypopharyngeal neuralgia, and a neurosurgical consultation should also be made promptly.
Convulsions: Convulsions caused by brain diseases are characterized by sudden, transient and recurrent attacks. It is often manifested as sudden onset of limb convulsions, which may extend to the whole body, and may be accompanied by impaired consciousness or incontinence, lasting from a few seconds to a few minutes each time, with a completely normal interictal period.
Fourth, limb weakness: can gradually aggravate or suddenly appear. Lighter ones often show early signs of inability to hold chopsticks, easy to drop them, and difficulty in holding things. If it is lower limb weakness, it is manifested as dragging walking, easy to bend or even fall on the knee, and the wear of the sole on the diseased side is obviously more serious than that on the healthy side. If the hand or foot cannot be lifted, or even the consciousness cannot control the movement of the hand and foot, it is the so-called “paralysis”.
V. Involuntary movements.
(1) Twitching: Involuntary twitching of the limbs, face, or chest and abdominal muscles that occurs and stops suddenly.
(2) Tremor palsy: involuntary rhythmic shaking of a part of the body or the whole body, accompanied by stiffness of the muscles and sluggish movements.
Sensory impairment: There are superficial sensations and deep sensations in the body. The superficial senses are pain, heat and cold, light touch and pressure, while the deep senses are the sensation of the position of the limb, the sensation of vibration and the sensation of movement when the person is closing. Diseases of the nervous system may cause these sensory abnormalities.
Visual field disorders: sudden or gradual decrease in visual acuity, reduced range of vision, if no ophthalmologic disease is found in the eye examination or if edema is found in the fundus manifestation, a neurosurgical consultation should be made, these conditions are often caused by intracranial lesions.
VI. Polyuria: the daily urine volume is more than 4000 ml, the urine is light or colorless and transparent, the patient feels thirsty and needs to drink a lot of water every day.
VII. Aphasia: It mainly refers to acquired language dysfunction or loss, which means that there is no deafness or mute originally, but the problem of language function appears later. Most of them are caused by lesions affecting the higher language center of the left side of the brain. It can manifest itself in the following ways.
(1) Motor aphasia: It is manifested by the ability to hear others and pronounce words, but not to speak or only to utter individual single words and unable to repeat them.
(2) Sensory aphasia: It is manifested as understanding the words of others and oneself, although pronouncing the words normally and speaking coherently, but often using the wrong words and answering the wrong questions.
(3) Naming aphasia: It is manifested as knowing the purpose of a thing but being unable to name the thing, but when others name something.
(4) Complete aphasia: Loss of both the ability to express and understand language, neither understanding what is said nor being able to speak the words.
(5) Loss of reading: Normal vision and the ability to read words is now lost.
(6) Loss of writing: Normal hand movement, but unable to write.
Menstrual abnormalities and lactation: irregular menstruation, irregular timing of each visit, low volume, or even no menstruation at all, breast milk secretion in the absence of childbirth, small volume requires squeezing the breast to overflow, large volume can automatically overflow mostly bilateral, mostly due to pituitary tumors, may be accompanied by vision loss.
Giantism in children, adult acromegaly, facial changes: pituitary growth hormone adenoma.
Abnormal growth and sexual development: Mostly caused by anterior or posterior lesions of the three ventricles, such as craniopharyngioma, teratoma, germ cell tumor, pineal tumor, etc.
Unsteady walking: skewing to one side, mostly due to cerebellar involvement.
Drowsiness, personality change, mental decline, etc.: lesions in the frontal lobe, temporal lobe or hypothalamus, etc.
IX. Meningeal irritation symptoms: sudden onset of headache, vomiting, and cervical tonicity are typical manifestations of subarachnoid hemorrhage. Acute infection in the skull.
X. Somatic pain: radioactive, weakness and numbness of one or both limbs, gradually progressing upward or downward, and urinary and fecal disorders, as a manifestation of spinal cord lesions.
XI. Symptoms of cranial nerve palsy: such as double vision, upper eyelids cannot be lifted, facial numbness, distorted mouth and eyes, drooling at the corners of the mouth, hearing loss, inability to swallow food, choking on water, abnormal pronunciation, hoarseness, etc., caused by brainstem, cranial nerve tumors and lesions in the adjacent parts of the skull base such as aneurysm, meningioma, chordoma, craniopharyngioma, pituitary tumor, nerve sheath tumor, etc.
XII. Other symptoms: vertigo, sudden coma, memory and judgment loss, etc.