How Many Times Can Gamma Knife Be Used

Overview

Gamma Pocketknife radiosurgery is a blazon of radiation therapy used to care for tumors, vascular malformations and other abnormalities in the brain.

Gamma Knife radiosurgery, similar other forms of stereotactic radiosurgery (SRS), is not surgery in the traditional sense because there is no incision.

Instead, Gamma Knife radiosurgery uses specialized equipment to focus about 200 tiny beams of radiation on a tumor or other target with submillimeter accurateness. Although each beam has very little upshot on the encephalon tissue it passes through, a stiff dose of radiations is delivered to the place where all the beams meet.

The precision of brain stereotactic radiosurgery results in minimal radiation commitment to healthy tissues surrounding the target.

Gamma Pocketknife radiosurgery is usually a one-time therapy completed in a unmarried day.

Why it'due south done

Gamma Knife radiosurgery is often a safer culling to standard brain surgery (neurosurgery), which requires incisions in the scalp, an opening in the skull and membranes surrounding the brain, and dissection into brain tissue. This type of radiation handling is normally performed when:

A tumor or other aberration in the brain is besides difficult to reach with standard neurosurgery
A person isn't healthy enough to undergo standard surgery
A person prefers a less invasive handling

In some cases, Gamma Pocketknife radiosurgery may have a lower risk of side effects compared with other types of radiations therapy and it tin can all be done in i day compared with up to thirty treatments with conventional radiation therapy.

Gamma Pocketknife radiosurgery is about commonly used to treat the following weather:

Brain tumor. Radiosurgery is useful in the management of modest noncancerous (benign) and cancerous (malignant) brain tumors.

Radiosurgery amercement the genetic material (Deoxyribonucleic acid) in the tumor cells. The cells lose their power to reproduce and may die, and the tumor may gradually shrink.
Arteriovenous malformation (AVM). AVMdue south are abnormal tangles of arteries and veins in your brain. In an AVM, blood flows from your arteries to veins, bypassing smaller blood vessels (capillaries). AVMs, if left untreated, may "steal" the normal menstruation of claret from the brain, causing a stroke, or lead to haemorrhage in the brain.

Radiosurgery destroys the AVM and causes the blood vessels to close off over fourth dimension.
Trigeminal neuralgia. Trigeminal neuralgia is a disorder of one or both of the trigeminal nerves, which relay sensory information between your brain and areas of your brow, cheek and lower jaw. This nerve disorder causes disabling facial hurting that feels similar an electric daze.

Subsequently treatment, many people will experience hurting relief within a few days to a few months.
Acoustic neuroma. An acoustic neuroma (vestibular schwannoma) is a noncancerous (benign) tumor that develops along the nervus of balance and hearing leading from your inner ear to your brain.

When the tumor puts pressure on the nerve, yous tin experience hearing loss, dizziness, loss of residual and ringing in the ear (tinnitus). Equally the tumor grows, it can too put force per unit area on the nerves affecting sensations and muscle motility in the face up.

Radiosurgery may stop the growth of an audio-visual neuroma.
Pituitary tumors. Tumors of the edible bean-sized gland at the base of operations of the brain (pituitary gland) tin can cause a multifariousness of problems. The pituitary gland regulates hormones in your torso that command various functions, such equally your stress response, metabolism and sexual function.

Radiosurgery can exist used to compress the tumor and lessen the disruption of pituitary hormone regulation.

Risks

Gamma Knife radiosurgery doesn't involve surgical incisions, and so information technology'south generally less risky than traditional neurosurgery. In traditional neurosurgery, there are potential complications associated with anesthesia, bleeding and infection.

Early complications or side effects are ordinarily temporary. Some people experience mild headaches, a tingling awareness 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 about the treatment site tin cause a variety of symptoms depending on what areas of the brain are involved. If post-handling swelling and symptoms do occur from the Gamma Knife handling, these symptoms unremarkably show up approximately six months afterwards treatment rather than immediately afterward the procedure similar with conventional surgery. Your doctor may prescribe anti-inflammatory medications (corticosteroid medications) to preclude such problems or to care for symptoms if they announced.
Scalp and hair problems. Your scalp may be red, irritated or sensitive at the four sites where the caput frame was attached to your caput during the treatment. But the head frame does non leave any permanent marks on the scalp. Rarely, some people temporarily lose a small corporeality of hair if the area beingness treated is right under the scalp.

Rarely, people may experience late side effects, such every bit other brain or neurological bug, months after Gamma Knife radiosurgery.

How you gear up

Food and medications

Don't eat or drink anything afterward midnight the night before the process.
Talk to your md about whether y'all can accept your regular medications the dark earlier or morning time of the process.

Clothing and personal items

Wear comfortable, loosefitting wear.

Avert wearing the following items during the process:

Jewelry
Eyeglasses
Contact lenses
Makeup
Nail smoothen
Dentures
Wigs or hairpieces

Other precautions

Tell your medico if you:

Are taking pills or injections to control diabetes
Are allergic to shellfish or iodine — both are chemically related to special dyes that may be used during the procedure
Accept implanted medical devices in your body, such as a pacemaker, artificial eye valve, aneurysm clips, neurostimulators or stents
Experience claustrophobia

What y'all can wait

Before the procedure

Earlier the procedure begins, you'll have a lightweight frame attached to your head with iv 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:

Your hair will not be shaved, but your hair may exist washed with a special shampoo
You'll receive numbing shots in the four places on your scalp where the pins will be inserted — two points on your brow and two at the back of your head

After the head frame is attached, yous'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 browse used depends on the condition existence treated:

Tumors. Imaging for tumors may include computerized tomography (CT) or magnetic resonance imaging (MRI). In a CT scan, a series of Ten-rays creates a detailed paradigm of your brain. In an MRI scan, a magnetic field and radio waves create detailed images of your brain.

A small needle may be placed in the back of your hand or in your arm to inject a dye into a claret vessel to view the blood vessels in your encephalon and highlight blood circulation. In some cases, you may have both MRI and CT scans.
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-scale tube in a claret vessel in your groin and threads it to the brain using X-ray imaging. Dye is injected through the blood vessels to make them visible on Ten-rays. Your doctor may inject a dye into a blood vessel during CT or MRI scans to view the blood vessels and highlight claret circulation.
Trigeminal neuralgia. An MRI or a CT scan is used to create images of nerve fibers to select a target area for treating trigeminal neuralgia.

The results of the encephalon scans are fed into a computerized planning system that allows the radiosurgery squad to decide the appropriate areas to care for, doses of radiation and how to focus the radiation beams to treat the areas. This planning process may take an hr or two. During that fourth dimension, you can relax in some other room, but the frame must remain fastened to your head.

Children are ofttimes anesthetized for the imaging tests and during the radiosurgery. Adults are unremarkably awake, but may be given a mild sedative to aid them relax.

During the procedure

Yous'll lie on a bed that slides into the Gamma Pocketknife machine, and your head frame will be attached securely to a helmet inside the car.

You'll have an intravenous (4) tube that delivers fluids to your bloodstream to go on you hydrated during the solar day. A needle at the end of the 4 is placed in a vein, about likely in your arm.

The time needed to complete the process may range from less than an hour to well-nigh four hours, depending on the size and shape of the target. During the process:

You won't experience the radiation
You won't hear any noise from the automobile
You'll be able to talk with the doctors via a microphone

Gamma Knife radiosurgery is usually an outpatient procedure, but the entire process will take most of a twenty-four hours. You lot may be advised to have a family member or friend who can be with you during the twenty-four hours and who can take you lot dwelling. In some cases, an overnight stay in the hospital may be necessary.

A patient undergoing stereotactic radiosurgery. Stereotactic radiosurgery system at Mayo Dispensary

After the process

After the process, you can expect the following:

The head frame will be removed.
You may have minor haemorrhage or tenderness at the pin sites.
If you feel headache, nausea or vomiting after the procedure, yous'll receive appropriate medications.
You'll be able to eat and beverage afterwards the process.

Results

The treatment consequence of Gamma Pocketknife radiosurgery occurs gradually, depending on the condition being treated:

Benign tumors. Gamma Pocketknife radiosurgery results in the failure of tumor cells to reproduce. The tumor may compress over a menstruation of xviii months to two years, just the main goal of Gamma Knife radiosurgery for benign tumors is to forestall whatever future tumor growth.
Cancerous tumors. Cancerous (cancerous) tumors may compress more than 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 manual of pain signals along the trigeminal nerve. Hurting relief may take several months.

You'll receive educational activity on appropriate follow-up exams to monitor your progress.