Brain Stereotactic Surgery

1 What is a Brain Stereotactic Surgery?

Gamma knife radiotherapy is a type of radiation therapy that is utilized in the treatment of tumors and other abnormalities in the brain.

In this procedure, specialized equipment focuses nearly 200 tiny beams of radiation on a tumor or another target.

Although each beam has a little effect on the tissue it passes through, a potent dose of radiation is delivered to the site where all the beams meet.

The accuracy mod gamma knife radiosurgery resulted in minimal damage  to the healthy tissues surrounding the target.

In the certain cases, gamma knife radiosurgery may have may have a lower risk  of side effects compared with other types of radiation therapy.

Also, gamma knife radiosurgery is often a safer option than the traditional brain surgery. Gamma knife radiosurgery is usually a one-time therapy completed in one day.

2 Reasons for Procedure

Here are the most common reasons to receive gamma knife radiosurgery.

Gamma knife radiosurgery does not involve any surgical incisions, this makes it less risky than the traditional neurosurgery procedure. Early or side effects are usually temporary.

They may include the following:

Fatigue. Exhaustion and fatigue may occur during the first few weeks after Gamma Knife radiosurgery.

Swelling. Swelling in the brain at or near the treatment site can cause symptoms such as a headache, nausea, and vomiting.

Your doctor may also make a prescription of anti-inflammatory medications to prevent such complications or to treat any symptoms if they appear.

Scalp and hair problems. You scalp may be red, irritated or sensitive at the site where the device is in contact with your head during the treatment. Some individuals temporarily lose a small amount of hair.

Rarely, people may experience late side effects, such as other brain or neurological problems, this usually occurs months after Gamma Knife radiosurgery.

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3 Potential Risks

Gamma knife radiosurgery doesn't involve surgical incisions, so it's generally less risky than traditional neurosurgery.

In traditional neurosurgery, you may have risks of complications with anesthesia, bleeding, and infection. Early complications or side effects are usually temporary.

They 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 symptoms such as a headache, nausea, and vomiting.

Your doctor may prescribe anti-inflammatory medications (corticosteroid medications) to prevent such problems or to treat symptoms if they appear.

Scalp and hair problems. Your scalp may be red, irritated or sensitive at sites where a device is attached to your head during the treatment. Some people temporarily lose a small amount of hair.

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

4 Preparing for your Procedure

To prepare for the gamma knife radiosurgery, you will be asked not to eat or drink anything after midnight, the night before your procedure.

Talk to your doctor about whether you can take you regular medications the night before the morning of the procedure.

Clothing and personal items. Remember o wear comfortable, loose-fitting clothes.

Avoid wearing the following items during the procedure:

  • Jewelry.
  • Eyeglasses.
  • Contact lenses.
  • Makeup.
  • Nail polish.
  • Dentures Wigs or hairpieces.

Precautions regarding medications and allergies.

Tell your doctor if you:

  • Are taking injections or pills to control diabetes.
  • Are allergic to shellfish or iodine, which are chemically related to special dyes that may be used during the procedure.
  • Have implanted medical devices in your body, such as a pacemaker, artificial heart valve, aneurysm clips, neurostimulators or stents.

5 What to Expect

Here you can find out what to expect from your gamma knife radiosurgery procedure.

Gamma knife radiosurgery is usually an outpatient procedure, but the entire process will take most of a day.

You may be advised to have a family member or friend who can be with you during the day and who can take you home. In some cases, an overnight stay in the hospital may be necessary.

You'll have an intravenous (IV) line, a tube that delivers fluids to your bloodstream to keep you hydrated during the day. A needle at the end of the IV is placed in a vein, most likely in your arm.

Before the procedure: Before the procedure begins, you'll have a lightweight frame attached to your head with four pins. This frame will stabilize your head during the radiation treatment and serve as a point of reference for focusing the beams of radiation.

During this process: None of your hair will be shaved You'll receive numbing shots in the four places on your scalp where the pins will be inserted — two points on your forehead and two at the back of your head After the head frame is attached, you'll undergo imaging scans of your brain that show the location of the tumor or other abnormality in relation to the head frame.

The type of scan used depends on the condition being treated: Tumors. Imaging for tumors may include computerized tomography (CT scan) or magnetic resonance imaging (MRI). In a CT scan, a series of X-rays create a detailed image of your brain.

In an MRI scan, a magnetic field and radio waves create detailed images of your brain. Doctors may inject a dye into a blood vessel to view the blood vessels in your brain and highlight blood circulation.

In some cases, you may have an MRI and CT scan. Arteriovenous malformations (AVMs). Imaging for brain AVMs may include CT scans, MRI scans, cerebral angiograms or some combination of these tests.

In a cerebral angiogram, a doctor inserts a small tube in a blood vessel in your groin and threads it to the brain using X-ray imaging. A doctor injects dye through the blood vessels to make them visible on X-rays.

Your doctor may inject a dye into a blood vessel during CT or MRI scans to view the blood vessels and highlight blood circulation.

Trigeminal neuralgia. An MRI or CT scan is used to create images of nerve fibers to select a target area for treating trigeminal neuralgia.

The results of the brain scans are fed into a computerized planning system that enables the radiosurgery team to plan the appropriate areas to treat, dosages of radiation and how to focus the radiation beams on treating the areas.

This planning process may take an hour or two. During that time, you can relax in another room, but the frame must remain attached to your head.

Children are often anesthetized for the imaging tests and during the radiosurgery. Adults are usually awake, but you may be given a mild sedative to help you relax.

During the procedure, You'll lie on a bed that slides into the Gamma Knife machine, and your head frame will be attached securely to a helmet inside the machine.

The procedure may take less than an hour to about four hours, depending on the size and shape of the target.

During the procedure:

  • You won't feel the radiation.
  • You won't hear any noise from the machine.
  • You'll be able to talk with the doctors via a microphone.

After the procedure, you can expect the following:

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

6 Procedure Results

The results of Gamma Knife radiosurgery occurs gradually, depending on the condition being treated:

Benign tumors. Gamma Knife radiosurgery results in the failure of tumor cells to reproduce.

The tumor may shrink over a period of 18 months to two years, but the main goal of Gamma Knife radiosurgery for benign tumors is to prevent any future tumor growth.

Malignant tumors. Cancerous (malignant) tumors may shrink more rapidly, often within a few months.

Arteriovenous malformations (AVMs). The radiation therapy causes the abnormal 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 lesion that blocks transmission of pain signals along the trigeminal nerve.

Pain relief may take several months. You'll receive instruction on appropriate follow-up exams to monitor your progress.

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