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  1. HOMEPAGE
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  4. BRAIN STEREOTACTIC RADIOSURGERY
Brain stereotactic radiosurgery
Last Updated on July 24, 2024
Overview

Gamma Knife radiosurgery is a type of radiation therapy. It can be used to treat tumors, veins that have developed differently than usual and other differences in the brain.

Similar to other types of stereotactic radiosurgery (STS), Gamma Knife radiosurgery is not a standard surgery because there is no cut, called an incision.

Instead, Gamma Knife radiosurgery focuses many tiny beams of radiation on a tumor or other target with extreme accuracy. Each beam has very little effect on the brain tissue it passes through. But a strong dose of radiation is delivered to the place where all the beams meet.

The treatment effect of Gamma Knife radiosurgery occurs slowly, depending on the condition being treated:

  • Benign tumors. Gamma Knife radiosurgery keeps tumor cells from reproducing. The tumor may shrink over a period of months to years. But the main goal of Gamma Knife radiosurgery for noncancerous tumors is to prevent any future tumor growth.
  • Malignant tumors. Cancerous tumors may shrink quickly, often within a few months.
  • Arteriovenous malformations (AVMs). The radiation therapy causes the atypical blood vessels of brain AVMs to thicken and close off. This process may take two years or more.
  • Trigeminal neuralgia. Gamma Knife radiosurgery creates a wound that blocks pain signals from moving along the trigeminal nerve. Pain relief may take several months.

    You'll have follow-up exams to monitor your progress.

Results
Results
Why it's done

Gamma Knife radiosurgery is often safer than standard brain surgery, also called neurosurgery. Standard surgery requires making incisions in the scalp, skull and membranes surrounding the brain, and cutting into brain tissue. This type of radiation treatment is usually performed when:

  • A tumor or other difference in the brain is too hard to reach with standard neurosurgery.
  • A person isn't healthy enough for standard surgery.
  • A person prefers a less invasive treatment.

In most cases, Gamma Knife radiosurgery has fewer side effects compared with other types of radiation therapy. This type of surgery can be done in one day compared with up to 30 treatments with typical radiation therapy.

Gamma Knife radiosurgery is most commonly used to treat the following conditions:

  • Brain tumor. Radiosurgery can manage small noncancerous, also called benign, brain tumors. Radiosurgery also can manage cancerous, also called malignant, brain tumors.

    Radiosurgery damages the genetic material known as DNA in the tumor cells. The cells cannot reproduce and may die, and the tumor may gradually get smaller.

  • Arteriovenous malformation (AVM). AVMs are tangles of arteries and veins in the brain. These tangles are not typical. In an AVM, blood flows from the arteries to veins, moving past smaller blood vessels, also called capillaries. AVMs, if not treated, may "steal" the typical flow of blood from the brain. This can cause a stroke or lead to bleeding in the brain.

    Radiosurgery causes the blood vessels in the AVM to close off over time. This lowers the risk of bleeding.

  • Trigeminal neuralgia. The trigeminal nerves move sensory information between the brain and areas of the forehead, cheek and lower jaw. Trigeminal neuralgia causes facial pain that feels like an electric shock.

    After treatment, pain relief can happen within a few days to a few months.

  • Acoustic neuroma. An acoustic neuroma, also called a vestibular schwannoma, is a noncancerous tumor. This tumor develops along the nerve that controls balance and hearing and leads from the inner ear to the brain.

    When the tumor puts pressure on the nerve, you can experience hearing loss, dizziness, loss of balance and ringing in the ear, also called tinnitus. As the tumor grows, it also can put pressure on the nerves that control sensations and muscle movement in the face.

    Radiosurgery may stop the growth of an acoustic neuroma.

  • Pituitary tumors. Tumors of the bean-sized gland at the base of the brain, called the pituitary gland, can cause several problems. The pituitary gland controls hormones in the body that control various functions, such as stress response, metabolism and sexual function.

    Radiosurgery can be used to shrink the tumor and lessen the irregular secretion of pituitary hormones.

Risks

Gamma Knife radiosurgery doesn't involve surgical openings, so it's generally less risky than standard neurosurgery. In standard neurosurgery, there are possible complications associated with anesthesia, bleeding and infection.

Early complications or side effects are usually temporary. Some people experience mild headaches, a tingling sensation on the scalp, nausea or vomiting. Other side effects may include:

  • Fatigue. Tiredness and fatigue may occur for the first few weeks after Gamma Knife radiosurgery.
  • Swelling. Swelling in the brain at or near the treatment site can cause several symptoms depending on what areas of the brain are involved. If post-treatment swelling and symptoms do occur from the Gamma Knife treatment, these symptoms usually show up about six months after treatment rather than immediately after the procedure like with standard surgery. Your health care professional may prescribe anti-inflammatory medicines, such as corticosteroids, to prevent such problems or to treat symptoms if they appear.
  • Scalp and hair problems. The skin on the scalp may change color or be irritated or sensitive at the four sites where the head frame was attached to the head during the treatment. But the head frame does not leave any permanent marks on the scalp. Rarely, some people temporarily lose a small amount of hair if the area being treated is right under the scalp.

    Rarely, people may experience late side effects, such as other brain or nerve problems, months or years after Gamma Knife radiosurgery.

How you prepare

Gamma Knife radiosurgery is usually an outpatient procedure, but the entire process may last into the afternoon. You may be asked to bring along a family member or friend who can be with you during the day and who can take you home. Rarely, you may stay overnight in the hospital.

What you can expect

After the procedure

After the procedure, you might expect the following:

  • The head frame will be removed.
  • You may have minor bleeding or tenderness at the pin sites.
  • If you experience headache, nausea or vomiting after the procedure, you'll receive medicines.
  • You'll be able to eat and drink after the procedure.
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