Evan Winograd, MD

A brain and spine primary-care practitioner — a concierge-style, holistic approach built around you, not your scan.

A brain and spine doctor — not just a surgeon

My job is NOT to sell you on surgery. It's to work with you on brain and spine problems with a realistic view of what's going on and what makes sense to do about it.

I built North County Neurosurgery around a simple idea: brain and spine care should help patients find realistic paths forward, not push everyone toward the same answer. Sometimes the right path includes surgery. Often it doesn't. Either way, you deserve a surgeon who has thought carefully about both routes before recommending one.

How I practice

The first job is diagnostic, not surgical. Before anyone talks about rods, screws, or incisions, I want to understand the specific structure driving your symptom. Rods and screws can absolutely be the right answer for the right problem — they should never be the default. Whenever it's reasonable, my goal is to help patients improve without surgery. When surgery is the right move, I aim to plan it around the specific pain generator: targeted, minimally invasive when feasible, and sized to the problem. For many patients, that approach can offer meaningful improvement from a smaller intervention and keeps larger options in reserve if they become necessary.

I also want to be candid about what this practice can and can't do. Not every problem in the brain or spine can be fully fixed. Many can be understood, managed, and improved; some need a focused surgical plan; some don't. My role is to help patients work through that — whether the right next step involves me, a different sub-specialist, or no surgical intervention at all.

What I treat — and what I don't

I see a broad mix of brain and spine cases: spine trauma, cranial trauma, brain tumors, spine tumors, minimally invasive degenerative spine (herniated discs, stenosis, radiculopathy, spondylolisthesis), and selected spine deformity. My neurosurgical oncology training gives me particular depth in brain and spine tumor work, including awake craniotomy for eloquent-area tumors and endonasal pituitary surgery.

Full condition library → conditions we treat and procedures offered.

I don't perform pediatric neurosurgery, functional neurosurgery (DBS, epilepsy-focused surgery), or endovascular / interventional neurosurgery (thrombectomy, coiling, embolization). If your condition falls outside my skillset, I'm still happy to see you. We'll figure out a reasonable next step together — often a referral to the right sub-specialist or coordination with your primary care physician — so you're not left navigating the system alone.

Why North County — and where we're going

NCN is the third step of a deliberate path. I started in metro Atlanta working to be the local point-of-contact neurosurgeon for primary care physicians and community patients. I took that model to Colorado as Medical Director of Neurosurgery at UCHealth Highlands Ranch, then chose San Diego to build it as my own practice. I love this coast, and I love that my patients here are actively trying to stay in their lives — surfing, hiking, working, traveling, keeping up with their families. That's a population worth designing a practice around.

The primary clinic sits just south of the I-5 / 78 interchange, chosen deliberately to be within reach of both the coast and inland North County. Additional clinic locations in Temecula and San Diego are coming soon— to meet patients closer to where they already live and receive the rest of their care.

Research, teaching, and community

Eleven peer-reviewed publications in neurosurgery and neuro-oncology, including co-authorship of the Congress of Neurological Surgeons' evidence-based guidelines on targeted therapies and immunotherapies for progressive glioblastoma (J Neurooncol, 2021) and first-author work on brainstem metastases radiosurgery, glioblastoma vaccines, and pituitary imaging. Earlier bench work at Roswell Park focused on exosome-based targets for glioma vaccines. Presentations at the Congress of Neurological Surgeons, Leksell Gamma Knife Society (Dubai), and the Israeli Surgical Association (Jerusalem), among others.

Teaching is a part of the job I enjoy — patients in the exam room, primary care colleagues in the community, residents and fellows in the lab, and premed students getting their first look at the OR.

A couple of small things

I speak English and am conversational in Spanish for clinical purposes; a professional interpreter is always an option. And if you're open to it, you may meet Kinley, my dog, who occasionally joins me in clinic when the day allows — entirely at your invitation.

Curious about the practice itself, rather than the surgeon? That lives on a separate page.