Understanding brain surgery: Clear signals and realistic outcomes
Wed Dec 17 2025
In this first episode of Beyond the Rounds, host Dr. Nolan Fisher sits down with internationally recognized neurosurgeon Dr. Dilan Ellegala to break down some of the most common conditions in cranial neurosurgery. Together, they walk through real clinical cases and discuss what every clinician should know about indications, imaging, surgical decision-making and how to avoid low-value neurosurgical care.Dr. Ellegala shares insights from his extensive training (University of Washington, University of Virginia, Brigham & Women’s/Harvard) and global health work, offering a grounded, practical lens for both primary care providers and specialists.What we cover in this episode:Meningioma evaluation & management– How vague headaches present– When to image– What MRI findings matter– Treatment pathways and realistic surgical outcomesPituitary tumors– Visual changes, hormonal symptoms & incidental findings– When surgery is indicated– Expected results from modern techniquesAneurysm case (subarachnoid hemorrhage)– Differentiating dangerous headaches from migraine– How CTA findings drive intervention– Red flags not to missTrigeminal neuralgia– Classic symptom patterns– Vascular compression on imaging– Medical vs. surgical managementMyth vs. MedicineDr. Ellegala addresses common patient fears — “brain tumors are always fatal,” “my head will be shaved,” “minimally invasive options don’t exist” — and reframes them with facts, outcomes data and modern neurosurgical approaches.Systems & ReferralsWe also break down:• What multidisciplinary neurosurgical care actually looks like• How coordinated pathways improve outcomes• What makes a high-quality referral (and where patients fall through the cracks)About Our Guest:Dilan Ellegala, MD, is a neurosurgeon specializing in cerebrovascular, skull base and microneurosurgery, with more than 50 publications and international work advancing global neurosurgical care.📌 Subscribe for upcoming episodes featuring real cases, practical insights and collaborative conversations across the spectrum of patient care.
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In this first episode of Beyond the Rounds, host Dr. Nolan Fisher sits down with internationally recognized neurosurgeon Dr. Dilan Ellegala to break down some of the most common conditions in cranial neurosurgery. Together, they walk through real clinical cases and discuss what every clinician should know about indications, imaging, surgical decision-making and how to avoid low-value neurosurgical care.Dr. Ellegala shares insights from his extensive training (University of Washington, University of Virginia, Brigham & Women’s/Harvard) and global health work, offering a grounded, practical lens for both primary care providers and specialists.What we cover in this episode:Meningioma evaluation & management– How vague headaches present– When to image– What MRI findings matter– Treatment pathways and realistic surgical outcomesPituitary tumors– Visual changes, hormonal symptoms & incidental findings– When surgery is indicated– Expected results from modern techniquesAneurysm case (subarachnoid hemorrhage)– Differentiating dangerous headaches from migraine– How CTA findings drive intervention– Red flags not to missTrigeminal neuralgia– Classic symptom patterns– Vascular compression on imaging– Medical vs. surgical managementMyth vs. MedicineDr. Ellegala addresses common patient fears — “brain tumors are always fatal,” “my head will be shaved,” “minimally invasive options don’t exist” — and reframes them with facts, outcomes data and modern neurosurgical approaches.Systems & ReferralsWe also break down:• What multidisciplinary neurosurgical care actually looks like• How coordinated pathways improve outcomes• What makes a high-quality referral (and where patients fall through the cracks)About Our Guest:Dilan Ellegala, MD, is a neurosurgeon specializing in cerebrovascular, skull base and microneurosurgery, with more than 50 publications and international work advancing global neurosurgical care.📌 Subscribe for upcoming episodes featuring real cases, practical insights and collaborative conversations across the spectrum of patient care.