When should I consult a neurosurgeon? Diseases of the central nervous system can show a variety of symptoms, if the following symptoms usually should go to the neurosurgery department: Headache: This is one of the most common symptoms of neurosurgery. Clinically, we often see patients with headaches suspecting that there is a tumor in the head, in fact, most of the headaches in daily life are functional, there is no organic lesion of the brain, only the following conditions should be timely to the neurosurgery: (1) acute onset of headache. Patients usually do not have headache symptoms, suddenly appeared severe headache even with vomiting, can be seen in intracranial hemorrhage, acute inflammation, tumor stroke; (2) repeated paroxysmal headache. Most commonly seen in vascular headache, epileptic headache, occipital neuralgia or cervical spondylosis, etc.; (3) gradually aggravating headache. Often suggests a gradual increase in intracranial pressure, if the headache aggravated by a gradual loss of vision, and headache accompanied by projectile vomiting, is a typical cranial hypertension “three signs”, 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 a knife cut, electric shock, burning or needles, and tends to appear suddenly when washing the face, brushing the teeth, eating or talking, the possibility of trigeminal neuralgia should be considered. In particular, it should be pointed out that trigeminal neuralgia is sometimes manifested as intolerable toothache, patients often go to the stomatology department first, can not wait to ask for tooth extraction, the result is often removed half of the big teeth, the pain is still not the slightest relief, and finally to the neurosurgery department. (2) If there is persistent vague, dull or distending pain in the face without obvious intervals, then we should consider the lesions around the trigeminal nerve and should go to the neurosurgery department. (3) If there is a transient sharp pain at the root of the tongue, the deep part of the mouth, or the deep part of the external auditory canal, which can often be induced by swallowing, it may be glossopharyngeal neuralgia, and the neurosurgery department should also be consulted promptly. Convulsions: Convulsions caused by brain diseases are characterized by sudden, transient and recurrent episodes. It is often characterized by sudden onset of limb convulsions, which may extend to the whole body, and may be accompanied by impaired consciousness or urinary and fecal incontinence, and lasts for a few seconds to a few minutes each time, with the interictal period being completely normal. Weakness of the limbs: it may be gradually aggravated or appear suddenly. The milder ones tend to show early on that they can’t hold chopsticks well, drop them easily, and have difficulty in holding objects. If the weakness is in the lower limbs, it shows that they can walk with a shuffling motion, the knees tend to be weak and bend or even fall, and the wear and tear of the soles of the shoes on the diseased side is obviously worse than that on the healthy side. If the hands or feet can not be lifted, or even the consciousness can not control the movement of the hands and feet, it is the so-called “paralysis”. Involuntary movements: (1) Twitching: Involuntary twitching of the limbs, face or chest and abdominal muscles that is not fixed, and that occurs and stops suddenly. (2) Tremor paralysis: involuntary rhythmic shaking of a part of the body or of the whole body, accompanied by rigidity of the muscles and sluggishness of movement. Sensory impairment: There are superficial and deep sensations in the human body. Superficial sensations include pain, heat and cold, light touch and pressure, while deep sensations refer to 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 disorder: sudden or gradual decrease in visual acuity, narrowing of the range of vision. If ophthalmologic examination does not reveal any ophthalmologic disease or if edema manifestations are found in the fundus of the eye, one should go to the neurosurgery department; these conditions are often caused by intracranial lesions. Polyuria: the urine volume is more than 4000 ml per day, the urine color is light or colorless and transparent, the patient feels thirsty and needs to drink a lot of water every day. Aphasia: mainly refers to acquired language dysfunction or loss, that is to say, originally there was no deafness or mute, but only later developed language function problems. Most of them are caused by the lesion on the left side of the brain’s higher language center. (1) Motor aphasia: It is manifested as being able to understand others’ words and pronounce them, but not being able to speak or only being able to utter individual single words and not being able to repeat them. (2) Sensory aphasia: It is manifested by understanding others’ and one’s own words. Although the pronunciation is normal and the speech is coherent, the words are often used incorrectly and the answers are not what they are supposed to be. (3) Naming aphasia: It is manifested by knowing the use of a thing but being unable to name the thing, but when someone else names something. (4) Complete aphasia: the loss of both the ability to express and understand language, neither understanding what is said nor being able to speak it. (5) Loss of Reading: Normal vision and formerly literate, but now the ability to read words is lost. (6) Loss of writing: normal hand movement, but unable to write. Abnormal menstruation and lactation: irregular menstruation, irregular time of each visit, small amount, or even no menstruation at all, breast secretion of milk occurs when there is no childbearing, small amount needs to be squeezed before overflowing from the breasts, and a large amount can overflow automatically Mostly bilaterally, mostly due to pituitary tumor, which can be accompanied by loss of eyesight. Gigantism in children, acromegaly in adults, facial changes: manifestations of pituitary growth hormone adenoma. Abnormal growth and development, abnormal sexual development: mostly caused by anterior or posterior lesions of the three ventricles, such as craniopharyngioma, teratoma, germ cell tumor, pineal gland tumor. Unsteady walking: skewed to one side, mostly due to cerebellar involvement. Drowsiness, personality change, intellectual decline, etc.: frontal lobe, temporal lobe or hypothalamus lesions. Symptoms of meningeal irritation: sudden headache, vomiting, and cervical rigidity are typical manifestations of subarachnoid hemorrhage. Acute infection within the skull. Somatic pain: radiating, weakness and numbness of one or both limbs, gradually progressing upward or downward, urinary and defecation disorders, as manifestations of spinal cord lesions. Symptoms of cranial nerve palsy: such as double vision, inability to lift the upper eyelid, facial numbness, crooked mouth and eyes, drooling at the corners of the mouth, hearing loss, inability to swallow food, choking on drinking water, abnormal pronunciation, hoarseness, etc., for the brainstem, cranial nerve tumors and adjacent parts of the base of the skull such as aneurysms, meningiomas, chordomas, craniopharyngiomas, pituitary tumors, neural sheath tumors, and so on. Other symptoms: vertigo, sudden coma, loss of memory and judgment.