Neuropsychological Assessment
A neuropsychological assessment is a series of simple, non-invasive tests that evaluate how your brain is functioning, including memory, attention, language, spatial awareness and decision-making ability.
In the context of neurosurgery, it acts like a detailed “map” of your cognitive abilities, revealing possible effects of a condition or an operation that may not be apparent on a routine neurological examination or on imaging such as MRI.
Dr Nektarios Mazarakis, Assistant Professor of Neurosurgery at Aristotle University of Thessaloniki, with specialist expertise in complex spinal conditions and neuro-oncology, works closely with neuropsychologists within multidisciplinary team meetings (MDTs).
He also holds a degree in Psychology from the University of Crete and places particular emphasis on the importance of a correct and comprehensive neuropsychological assessment. This holistic approach allows more accurate diagnosis, individualised treatment planning and better clinical outcomes.
What is its role in neurosurgery
A problem in the brain, such as a tumour, aneurysm or injury, does not affect only movement or sensation. It may also affect thinking, memory or behaviour in ways that are not always immediately obvious.
Neuropsychological assessment gives the neurosurgeon a more complete picture of the patient’s condition, beyond visible motor or sensory symptoms, helping to support safer surgical decision-making.
What does it assess
The assessment is carried out by a neuropsychologist, in collaboration with the neurosurgeon, and usually lasts 1 to 2 hours. Standardised, evidence-based tests are used to evaluate:
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Memory (for example, recall of words or stories)
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Attention and concentration
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Spatial perception (for example, drawing shapes)
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Executive function (the ability to organise, plan and make decisions)
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Language function (particularly important when the lesion is close to areas of the brain responsible for speech)
These tests, often also referred to as “memory tests”, are straightforward for the patient and do not cause any discomfort or risk.
When is it needed
Neuropsychological assessment is usually recommended:
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Before surgery, in order to document the patient’s baseline cognitive profile and identify any critical areas, such as language areas, that need to be protected during the operation
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After surgery, to assess recovery and identify any changes
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During brain surgery, when the lesion is close to areas of the brain controlling important functions such as movement and speech, and the operation is performed with the patient awake
Why is it important
Neuropsychological assessment is not simply a diagnostic tool; it has practical value at every stage of care:
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Before surgery: It helps the team plan the safest possible approach, minimising the risk of damage to functionally critical areas.
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During recovery: It provides information on how cognitive function is evolving and whether individualised rehabilitation is needed, such as memory exercises or cognitive rehabilitation.
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Long term: It helps with planning the patient’s return to everyday life and work, with realistic expectations based on objective data.