TY - JOUR T1 - Highlights from this issue JF - Practical Neurology JO - Pract Neurol SP - 171 LP - 171 DO - 10.1136/practneurol-2017-001683 VL - 17 IS - 3 AU - Geraint N Fuller AU - Phillip E M Smith Y1 - 2017/06/01 UR - http://pn.bmj.com/content/17/3/171.abstract N2 - Primum non nocere; ‘First, do no harm’ is a fundamental principle in medicine. Neurologists’ thinking is often led by this principle when considering referring a patient for neurosurgery. Consider a 35-year-old man who presents with a single seizure and his scan shows what looks like a low-grade glioma. Such patients could easily be followed for many years with repeated scans and little progression, but with the knowledge that they would, at some stage, deteriorate as the tumour transforms. Against this, there is no such thing as a minor neurosurgical operation and the patient may be left with post-operative deficits. Should he have surgery? Do the risks outweigh the benefits? Is an operation not just feasible but also desirable? Caroline Hayhurst updates us ( see page 183 ) with the information needed to inform this difficult decision in people with low-grade gliomas. … ER -