Patient Guide
Your Scan Found Something. Do You Need a Neurosurgeon?
An MRI or CT report can mention an aneurysm, a lesion, a disc problem or a word you have never seen before, sometimes before anyone has had a chance to explain it. Here is what common findings mean, which ones a neurosurgeon should look at, and how to have your scan reviewed.
Share only your name and how to reach you. Please do not send scan results through the website or chat.
Brain, spine and cerebrovascular findings. Every case is evaluated by Dr. Shah-Naz Khan, MD, FRCSC, FAANS, directly. About Dr. Khan
First, check whether it is urgent
Call 911 now if you have any of these symptoms, even if they go away
Whatever the report says, these need emergency care. Do not wait, and do not drive yourself.
- A sudden, severe headache that peaks within seconds to minutes, or feels like the worst headache of your life
- A severe headache with a stiff neck, repeated vomiting or unusual drowsiness
- New weakness, numbness or drooping on one side of the face or body
- Sudden trouble speaking or understanding speech
- Sudden loss of balance or coordination
- Sudden loss of vision, double vision, or a newly drooping eyelid
- Loss of consciousness, confusion, or a seizure
- Weakness or numbness in both arms or both legs that is getting worse quickly, or new trouble walking
- New numbness around the groin, buttocks or inner thighs, new trouble passing urine, or loss of bladder or bowel control
Already know about a finding, such as an aneurysm, a vascular malformation or pressure on the spinal cord? Do not wait for a scheduled appointment if new symptoms start. Call 911 for any symptom above. For any other new or worsening symptom, call the doctor who ordered your scan, and if you cannot reach anyone, go to an emergency department.
If the report describes a new bleed, a new stroke, or pressure on the brain or spinal cord
Reports often use words such as acute hemorrhage, acute infarct (a new stroke), mass effect, midline shift, hydrocephalus, venous sinus thrombosis or cord compression to say that something was not found, as in "no acute hemorrhage" or "no midline shift". That is a normal result.
If your report says one of these findings is present and nobody has contacted you, call the doctor who ordered the scan now, using their after-hours line if the office is closed. If you cannot reach anyone, go to an emergency department.
If the report says the finding is unchanged from an earlier scan, it is usually not an emergency. Contact the ordering doctor's office when it opens.
Do not stop or change any medication because of a scan result unless a doctor tells you to.
The short answer
Modern scans are very detailed, and they often show things that are not causing any symptoms alongside things that need follow-up. A radiology report describes what the images show. Deciding what a finding means for you also depends on your symptoms, your examination and any older scans, which is what the doctor who ordered the scan, or a specialist, adds.
You can get your own report and images
You have a right to copies of your records, including the images themselves. Ask the facility that did the scan for them on CD or USB.
Not sure about a referral?
Requirements vary by insurer and location. If you have a referral, it helps with coordination. If not, contact us and we will advise the best next step.
A finding does not automatically mean surgery
A specialist review may end with reassurance, monitoring with a repeat scan, further tests, or a discussion of treatment options.
Common findings, and who usually looks at them
Radiology reports use technical words. These plain-English descriptions are general information to help you ask good questions. They are not an interpretation of your scan.
Blood vessels
Aneurysm
The report may say: aneurysm, saccular aneurysm, outpouching
A bulge in the wall of an artery in the brain. An unruptured aneurysm is usually found by chance on a scan done for another reason. Whether to treat it or monitor it depends on its size, location and shape, your age and health, and your personal and family history. If a scan of the abdomen or lower back mentions an aneurysm of the aorta, the main artery in the abdomen, that is a different condition handled by a vascular specialist.
Who usually reviews it: a cerebrovascular or endovascular neurosurgeon.
Vascular malformation
The report may say: arteriovenous malformation (AVM), cavernous malformation, cavernoma, dural arteriovenous fistula
An abnormal cluster or connection of blood vessels in or around the brain. The right approach depends on the type, where it is, and whether it has bled or caused symptoms.
Who usually reviews it: a cerebrovascular or endovascular neurosurgeon.
Carotid stenosis
The report may say: carotid stenosis, internal carotid artery narrowing, carotid plaque
Narrowing of one of the main arteries in the neck that supply the brain, often from a buildup of plaque. It is usually found on ultrasound, CT angiography or MR angiography. If it has caused stroke-like symptoms, even brief ones that went away, such as sudden loss of vision in one eye or weakness on one side, it needs urgent review. If symptoms are happening now, call 911.
Who usually reviews it: a cerebrovascular or vascular specialist. Mild plaque without significant narrowing is usually managed by your primary care doctor.
Brain
Meningioma
The report may say: likely meningioma, dural-based mass, dural tail
A tumor that grows from the membranes covering the brain. They are usually slow-growing and usually benign, and small ones that cause no symptoms are often monitored with repeat scans rather than treated right away.
Who usually reviews it: a neurosurgeon.
Mass or lesion
The report may say: mass, lesion, enhancing lesion, space-occupying lesion
Lesion simply means an area that looks different from the tissue around it. It has a range of possible causes, and not all of them are tumors. Further imaging is sometimes needed before anyone can say what it is.
Who usually reviews it: it depends on what the report suggests. A neurosurgeon for a suspected tumor or a mass pressing on the brain. A neurologist when the report suggests inflammation or demyelination. The doctor who ordered the scan can usually tell you which.
Chiari malformation
The report may say: Chiari I malformation, tonsillar ectopia, low-lying cerebellar tonsils, syrinx
The lowest part of the cerebellum sits lower than usual, into the opening at the base of the skull. It is sometimes found by chance, and it may need no treatment if it is not causing symptoms. Headaches brought on by coughing or straining, or a fluid-filled cavity in the spinal cord called a syrinx, are reasons to have it reviewed.
Who usually reviews it: a neurosurgeon.
Spine
Disc bulge or herniation
The report may say: disc bulge, protrusion, herniation, extrusion
Changes in the discs between the vertebrae. They often show up in people with no back or neck pain, so what matters is whether the finding fits your symptoms, such as pain, numbness or weakness running down an arm or a leg.
Who usually reviews it: often your primary care doctor first, who may suggest physical therapy. A neurosurgeon if symptoms are severe, getting worse, include weakness, or the report says the disc is pressing on the spinal cord.
Spinal stenosis
The report may say: spinal stenosis, canal narrowing, foraminal narrowing
Narrowing of the spaces the spinal cord and nerves pass through. In the lower back, it matters when it causes symptoms, such as leg pain or heaviness when walking that eases when you sit or bend forward. In the neck, narrowing can press on the spinal cord and cause clumsy hands or unsteady walking. See spinal cord compression below.
Who usually reviews it: a neurosurgeon, if the symptoms limit you or are getting worse.
Spinal cord compression
The report may say: cord compression, cord flattening, cord signal abnormality, myelomalacia, myelopathy
Pressure on the spinal cord itself. When pressure in the neck causes symptoms, such as clumsy hands or unsteady walking, it is called cervical myelopathy. A new finding needs prompt specialist review. Go to an emergency department if symptoms come on suddenly or get worse quickly, or if you have new trouble passing urine or controlling your bladder.
Who usually reviews it: a neurosurgeon, promptly.
Compression fracture
The report may say: compression fracture, loss of vertebral body height
A vertebra that has partly collapsed. It is often linked to osteoporosis, and sometimes to an injury or to a tumor in the bone.
Who usually reviews it: your primary care doctor, and a spine specialist if the pain is severe or not improving. See a spine specialist promptly if you have a history of cancer, or the report mentions retropulsion or a possible underlying lesion. New weakness, numbness or bladder change needs emergency care.
Degenerative changes
The report may say: degenerative changes, spondylosis, degenerative disc disease, facet arthropathy
Wear in the spine that usually comes with age. On its own it is often not the cause of symptoms.
Who usually reviews it: your primary care doctor, who may suggest physical therapy. A neurosurgeon if the report says nerves or the spinal cord are being pressed on, or you have pain, numbness or weakness running down an arm or a leg.
Often not a neurosurgery question
White matter changes
The report may say: white matter hyperintensities, nonspecific T2 or FLAIR foci, area of abnormal signal, small vessel ischemic change
Small bright spots on a brain MRI. They can come with age, migraine and blood vessel risk factors such as high blood pressure.
Who usually reviews it: usually your primary care doctor or a neurologist.
Sinus thickening (the air spaces behind the nose and cheeks)
The report may say: mucosal thickening, sinus disease
Often found by chance on head scans, and usually of no significance.
Who usually reviews it: your primary care doctor, or an ear, nose and throat specialist if you have sinus symptoms.
Age-related volume loss
The report may say: age-related volume loss, atrophy
Usually describes changes that come with aging. If the report says it is more than expected for your age, or that the fluid spaces in the brain look enlarged, ask your doctor what it means, especially if you have changes in memory, walking or bladder control.
Who usually reviews it: your primary care doctor, or a neurologist if you have concerns about memory or thinking.
Other terms that usually need no treatment
These often appear on reports and usually need no treatment on their own:
- Developmental venous anomaly: a variation in how a vein drains part of the brain
- Vertebral hemangioma: a blood vessel growth inside a vertebra
- Disc desiccation: a disc that has lost some water with age
- Annular fissure or tear: a small split in the outer ring of a disc
- Tarlov cyst: a fluid-filled sac on a nerve root at the base of the spine
- Arachnoid cyst: a fluid-filled space between the brain and its covering
If you are unsure, the doctor who ordered the scan can confirm what it means for you.
Having a neurosurgeon review your MRI or CT
Get the images, not just the report
Ask the facility that performed the scan for the images on CD or USB and the written radiology report. If you have older scans of the same area, ask for those too. Comparing them often tells a specialist more than either scan alone.
Decide who to ask
If your doctor suggests a specialist, you can ask which one and why. You can also ask your doctor to refer you to a particular neurosurgeon, and if your plan has a network, check that the neurosurgeon is in it.
Contact us
Call (810) 212-4100, or send an inquiry with just your name and how to reach you. Please do not put scan results or other health details in the web form or the website chat. We will contact you and advise the best next step.
Your review with Dr. Khan
She looks at the images themselves, compares them with any older scans, and relates them to your symptoms and examination. Then she explains what the finding is, whether it needs anything at all, and what the options are.
Dr. Khan explains every option, including not operating, and recommends surgery only when the benefit clearly outweighs the risk. The outcome of a review may be reassurance, monitoring, further tests, or a discussion of treatment.
Questions to ask about your finding
Whoever you see, these questions help you get a clear answer.
- What exactly was found, and where?
- Is it new, or was it on an earlier scan?
- Could it explain my symptoms?
- Does it need treatment, monitoring, or nothing at all?
- What would happen if we waited?
- Which specialist handles this, and why?
Already been given a recommendation? How a second opinion works
Scan questions
Why would I be referred to a neurosurgeon after an MRI?
Usually because the scan shows something a neurosurgeon is trained to assess, such as an aneurysm, a tumor, a Chiari malformation, or a disc or narrowing pressing on nerves or the spinal cord. A referral is a request for an expert opinion. It does not necessarily mean you will need surgery.
Can I see a neurosurgeon about my scan without a referral?
Requirements vary by insurer and location. If you have a referral, it helps with coordination. If not, contact us and we will advise the best next step.
What does incidental finding mean?
It means something was noticed that was not the reason the scan was done. Incidental findings range from harmless variations to things that need follow-up, and the report alone does not always tell you which. The doctor who ordered the scan can usually explain it, and a specialist review can help when it is less clear.
Should I worry about a disc bulge on my MRI?
Not necessarily. Disc bulges and degenerative changes often show up on scans of people with no back pain. What matters is whether the finding matches your symptoms. Severe or worsening pain, weakness, or numbness running down a leg are reasons to have it reviewed. New numbness around the groin or buttocks, or new trouble with bladder or bowel control, needs emergency care: call 911.
My doctor says it is nothing to worry about, but I am still worried. What can I do?
Start by telling your doctor you are still worried and asking what makes them confident. If you would still like another view, it is reasonable to ask for a specialist opinion, and a review can often confirm the reassurance.
How quickly should a finding be reviewed?
It depends on what was found and on your symptoms. Ask the doctor who ordered the scan what timeframe they recommend. Call 911 for a sudden, severe headache, new weakness or numbness, trouble speaking, or loss of bladder or bowel control. If the report describes a new bleed or new pressure on the brain or spinal cord, contact the ordering doctor right away. For other questions about a brain, spine or blood vessel finding, call us and we will advise the best next step.
Can you look at a scan done at another hospital?
Yes. Bring the images on CD or USB along with the radiology report. Reviewing outside imaging is a routine part of both first consultations and second opinions.
Can I send my scan or report through the website?
Please do not. The forms on this website are not a secure channel for health information. Bring documents to your appointment, arrange delivery through your current practice, or call the office and we will tell you the safest way to send them.
Source for your right to copies of your records, including images: 45 CFR 164.524. Checked September 2026.
This page is general information written by a neurosurgical practice to help you decide whether to have a finding reviewed. It is not an interpretation of your scan or a diagnosis, and it is not a substitute for being examined.
Ask about your scan
Call us, or request a call back with just your name and how to reach you, and we will advise the best next step.