Most patients are diagnosed with a brain tumor that is already very large. The reason is that brain tumors often present with headache, dizziness, visual disturbance and vomiting at the beginning of the attack, and neurosurgery is not thought of at the first visit. What are the symptoms that require neurosurgery? 1. 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 brain lesion, only the following cases should be promptly seen by neurosurgery: Acute attack headache: the patient usually has no headache symptoms, but suddenly appears severe headache or even vomiting, which can be seen in intracranial hemorrhage, acute inflammation, tumor stroke, etc.; Recurrent If the headache is aggravated by a gradual increase in intracranial pressure, and if the headache is accompanied by vomiting, it is a typical “three main signs” of cranial hypertension, which are mostly caused by neurosurgical diseases. It is caused by neurosurgical diseases. Facial pain includes pain in the face, eyes, nose, mouth and teeth. 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 pins and needles, and it is easy to appear suddenly when washing the face, brushing teeth, eating or talking, the possibility of trigeminal neuralgia should be considered. In particular, 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 their big teeth are often extracted and the pain is still not relieved in any way before they finally go to neurosurgery. 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. If there is 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, then it may be linguopharyngeal neuralgia, and neurosurgery should also be consulted promptly. Convulsions caused by brain diseases have the characteristics of sudden onset, transient and recurrent. 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 several minutes each time, with interictal periods completely normal. 4, limb weakness can gradually worsen or suddenly appear. In milder cases, the early manifestation is often the inability to hold chopsticks, easy to drop them, and difficulty in holding things. If the weakness is in the lower extremities, it is manifested as a dragging walk, easy to bend the knee or even fall down, and the wear of the sole of the affected side is obviously more serious than that of the healthy side. If the hand or foot cannot be lifted, or even consciousness cannot control the movement of the hand and foot, it is the so-called “paralysis”. 5. Involuntary movements (1) Twitching: Involuntary twitching of the limbs, face or chest and abdominal muscles that occurs and stops suddenly. (2) Tremor paralysis: involuntary rhythmic shaking of a part of the body or the whole body, accompanied by muscle stiffness and motor retardation. (3) 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, vibration and movement when the person is closing. Diseases of the nervous system may cause these sensory abnormalities. (4) Visual field disorders: sudden or gradual decrease in visual acuity and reduction in the range of vision. If no ophthalmologic disease is found in the ophthalmologic examination or if edema is found in the fundus manifestations, a neurosurgical consultation should be made, and these conditions are often caused by intracranial lesions. (5) 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. (6) Aphasia: It mainly refers to acquired language dysfunction or loss, which means that there was no deafness or mute originally, but the problem of language function appeared later. Most of them are caused by lesions affecting the higher language centers of the left side of the brain. Motor aphasia: It is manifested by the ability to hear and understand other people’s words, to pronounce them, but not to speak or to say individual single words and not to repeat them. Sensory aphasia: The condition is characterized by the ability to understand the speech of others and oneself. Although the pronunciation is normal and the speech is coherent, the words are often used incorrectly and the answer is not what is asked. Naming aphasia: It is manifested as knowing the purpose of an object but being unable to name the object, but when someone else says the name of something. Complete aphasia: Loss of both the ability to express and understand language, neither understanding what is said nor being able to speak the words. (7) Loss of reading: Normal vision and the ability to read words is now lost. (8) Loss of writing: normal hand movement, but cannot write. Abnormal menstruation and lactation: Irregular menstruation, irregular timing of each visit, low volume, or even no menstruation at all. Breast milk secretion occurs in the absence of childbirth, with low volume requiring squeezing of the breast to overflow, and high volume spontaneously overflowing mostly bilaterally, mostly due to pituitary tumors, and 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. Unstable 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. Meningeal irritation symptoms: sudden onset of headache, vomiting, and cervical tonicity are typical manifestations of subarachnoid hemorrhage. Acute infection within the skull. Somatic pain: radioactive, weakness and numbness of one or both limbs, progressive upward or downward, and urinary and fecal disorders, as a manifestation of spinal cord lesions. 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., as a result of brainstem and cranial nerve tumors and lesions in adjacent parts of the skull base such as aneurysm, meningioma, chordoma, craniopharyngioma, pituitary tumor and nerve sheath tumor. Other symptoms: vertigo, sudden coma, memory and judgment loss, etc.