FAQs

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  • What is Gamma Knife Radiosurgery?

    Gamma Knife Radiosurgery is a major advance that has changed the landscape within the field of neurosurgery. It has become a primary treatment for brain tumors, arteriovenous malformations, trigeminal neuralgia and other disorders.  Gamma Knife makes it possible for patients to undergo a non-invasive form of brain surgery without trauma, surgical risks, a long hopsital stay or subsequent rehabilitation. Gamma Knife is often the only treatment option for inoperable lesions and for patients who were formerly considered untreatable or at very high risk for open skull surgery. 

    Gamma Knife radiosurgery is a minimally invasive technique that is an alternative to conventional neurosurgery for many indications. Diseased tissue is treated with a single precisely-focused destructive dose of gamma rays. Normal brain tissue adjacent to the diseased tissue receives little radiation. Gamma Knife is a revolutionary breakthrough in brain surgery technology.

    Who determines if Gamma Knife Radiosurgery is appropriate?

    Medical necessity can be determined by a neurosurgeon, radiation oncologist or other medical specialist after evaluating a prospective patient’s medical condition. Treatment options are then determined and discussed with the patient and family so an informed decision can be made.

    Is it effective?

    Over 500,000 patients worldwide have chosen Gamma Knife Radiosurgery for treatment of benign tumors such as acoustic neuromas, meningiomas, pituitary adenomas, pineal tumors; malignant tumors like metastatic tumors, astrocytomas and glioblastomas. The Gamma Knife has also been used to eradicate arteriovenous malformations (AVM) and treatment protocols are under investigation for certain functional disorders such as chronic pain, trigeminal neuralgia, and Parkinson’s disease.

    Patients may be eligible for Gamma Knife Radiosurgery even if they have previously had open brain surgery, radiation therapy, chemotherapy, or in the case of AVM, embolization procedure. Results have proven to be superior or comparable to conventional neurosurgery, depending on the specific condition treated.

    Is it safe?

    Gamma Knife Radiosurgery is unique because no surgical incision is performed to “expose” the lesion. Consequently, the risk of surgical complication is greatly reduced. Patients are routinely administered a mild sedative, eliminating the side effects of general anesthesia. Patients are usually able to leave the treatment center the same day and resume their normal activities.

    What’s involved in a treatment?


    On the day of the treatment, the Gamma Knife patient will have a lightweight frame attached to the head. This frame is used as the most accurate system to target the lesion; and, is applied under local anesthetic with four pins. With the frame in place, the patient receives an MRI or CT imaging study, or angiography in the case of arteriovenous malformation, to precisely locate the diseased area to be treated.

    The frame ensures the highest accuracy. Without the frame, if the patient moves, the target is lost. With the frame, the patient’s head is totally immobilized and basically becomes part of the machine. The combination of a stationary (fixed source) radiation delivery system with a frame that securely fastens onto the equipment itself creates a highly stable system that facilitates accuracy. 

    Data from the imaging study is transferred to the Gamma Knife computer system. While the patient rests, the Gamma Knife Center team uses advanced software to determine the treatment plan. This takes one or two hours to complete depending on the complexity and location of the diseased area.

    When the individualized treatment plan is completed, the patient is placed on the Gamma Knife couch and is comfortably positioned. The patient is then moved automatically head first into the Gamma Knife and treatment begins. Treatment typically lasts from 15 minutes to an hour, during which time the patient feels nothing unusual. At the completion of the treatment the patient is automatically moved out of the Gamma Knife, and the head frame is removed. Patients are usually able to leave the treatment center the same day and resume their normal activities. The patient’s physician will arrange periodic follow-up examinations and brain imaging to follow the effects of treatment.

    The results of the Gamma Knife radiosurgery appear over days, weeks, or months, depending on the type of lesion being treated. Most lesions dissolve or sclerose gradually, eventually disappearing. Others simply exhibit no further growth.

    Data from the imaging study is transferred to the Gamma Knife computer system. While the patient rests, the Gamma Knife Center team uses advanced software to determine the treatment plan. This takes one or two hours to complete depending on the complexity and location of the disease.

    When the individualized treatment plan is completed, the patient is placed on the Gamma Knife couch and is precisely positioned.

    The patient is then moved automatically, head first into the Gamma Knife and treatment begins. Treatment typically lasts from 15 minutes to an hour, during which time the patient feels nothing unusual. At the completion of the treatment the patient is automatically moved out of the Gamma Knife and the head frame is removed. After a period of rest the patient may be discharged or if medically necessary stay overnight in the hospital for observation.

    When can I expect after treatment?

    The effects of Gamma Knife Radiosurgery occur over a period of time that can range from days to several months, depending on the type of medical condition treated. Some abnormalities dissolve gradually, eventually disappearing. Others simply exhibit no further growth.  The majority of patients are able to return to their normal daily activities the day after treatment.

    What are the patient benefits?

    Cost studies have shown Gamma Knife Radiosurgery to be less expensive than conventional neurosurgery because it eliminates lengthy post-surgical hospital stays, expensive medication and sometimes months of rehabilitation. Importantly, there are virtually no post-surgical disability and convalescent costs with this procedure. Gamma Knife Radiosurgery is reimbursed by most insurance companies, PPO’s, HMO’s, and Medicare.

    What disorders can Gamma Knife treat?

    Gamma Knife radiosurgery has been extensively tested and proven effective in treating:

    • Tumors within the head from a primary site elsewhere in the body: metastatic tumors.
    • Tumors originating within the brain itself or its coverings: pituitary tumors, acoustic neuromas, certain gliomas and meningiomas, etc.
    • Trigeminal neuralgia.
    • Abnormal blood vessels: arteriovenous malformations.
    • Tremors and other functional disorders.

    What are the results of Gamma Knife Radiosurgery?

    The majority of brain tumors selected for treatment will disappear or stop growing over time.

    Metastatic brain tumor before treatment Metastatic brain tumor 2 months after treatment
     

    After one year 40% of arteriovenous malformations are cured increasing to 80% two years after treatment. The risk of spontaneous bleeding during this time is not more than untreated malformations.

    Arteriovenous malformation before treatment After treatment
     

    Case treated by Ladislau Steiner MD PhD & Dheerendra Prasad MD, Lars Leksell Center for Gamma Knife Radiosurgery, Charlottesville VA.

    Cavernous sinus meningioma before treatment After treatment
     

    Case treated by Ladislau Steiner MD PhD & Dheerendra Prasad MD, Lars Leksell Center for Gamma Knife Radiosurgery, Charlottesville VA.

    What are the advantages of Gamma Knife Radiosurgery?

    Gamma Knife surgery has many advantages compared with traditional surgery and other types of radiation treatment.

    • Superior outcomes documented by 20 years of studies and peer-reviewed medical journals
    • Designed specifically to treat brain disorders providing greater accuracy than other radiosurgery systems
    • Delivers significantly lower dose of radiation to surrounding healthy tissue than CyberKnife, linear accelerator, or fractionated radiation therapy
    • Utilizes stereotactic frame technology that defines the standard for radiosurgery accuracy (especially vital for small tumors near sensitive neural structures)
    • Imaging, planning and treatment performed on the same day, as an outpatient procedure
    • Higher rates of patient satisfaction than microsurgery
    • No incisions or general anesthesia
    • No risk of intracranial bleeding or infection
    • Low risk of post-surgical complications
    • Rapid return to normal activities
    • No hair loss or scarring
    • Long term control of tumors and other disease
    • Indicated by the FDA for the treatment of brain metastases
    • Considered the “Gold Standard” of radiosurgery

    What are the complications of Gamma Knife Radiosurgery?

    Complications are infrequent or rare compared to conventional surgery. The most commonly reported complications are local pain or swelling at the site of the pin placement and/or headache that is resolved with over-the-counter medication.