Cranial neurosurgery represents the most exacting edge of surgical practice, where structure, function, and identity converge. This episode introduces the core principles of cranial anatomy, intracranial pressure, cerebral perfusion, and the surgical management of brain tumours, haemorrhage, trauma, and hydrocephalus.

Listeners are guided through how neurosurgeons localise lesions, interpret imaging, and balance intervention against risk. The episode also explores perioperative neurological assessment and the ethical weight of operating in a space where outcomes can fundamentally alter personhood.

This chapter teaches restraint as much as action — reminding clinicians that sometimes the most skilful decision is knowing when not to operate.

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