Medi-Sci Updateby Rizvend Pecana, RN Gamma Knife surgery, otherwise known as stereotactic radiosurgery involves a single dose of precisely targeted radiation noninvasively destroying an intracranial lesion. The Gamma Knife was introduced in 1967 by Lars Leksell, MD, a Swedish neurosurgeon, and more than 20 units are now in use in the U.S. More than 60,000 patients have been treated worldwide since its introduction. The $3.5 million machine replaces the surgeon's scalpel with a single, high dose of gamma radiation emitted by a cobalt-60 source. The patient wears a helmet with 201 small round holes in it that aim the radiation so that 201 narrow beams of gamma rays are all aimed at a single tiny target. The tissue being treated thus receives a very strong dose of radiation without harming non-target living cells along the way. The procedure takes about 15-40 minutes to perform, depending on the size of the area needing treatment. It is also done under mild sedation. A team of Neurosurgeons, radiation oncologists, physicists, and nurses provides patient selection, treatment, and quality assurance for the radiosurgery program. Obliterating arteriovenous malformations in the brain is a leading use for the Gamma Knife. Other uses include the treatment of trigeminal neuralgia, skull base meningiomas, and acoustic schwannomas. It differs from traditional surgery in that the tumor is not completely destroyed at the time of operation but rather undergoes necrosis or growth arrest over a period of time. Most Patients are able to leave the hospital within 24 hours of their Gamma Knife treatment. Normal activities and diet may be resumed. Follow up is an extremely important aspect of Gamma Knife Treatment. Imaging (MRI, angiogram or CT Scan) studies are frequently undertaken at three, six, 12, 18 and 24 months after Gamma Knife procedure in order to evaluate the response to treatment. Because of the advances in this field of treatment, the patient does not have to undergo a lengthy recovery period due to the effects of generalized anesthesia and the process of wound healing encountered with traditional brain surgery. Other than mild nausea or headache which are probably related to the application of and removal of the guiding device, there are usually no immediate side effects of Gamma Knife treatment. Possible side effects include reduced hearing, vision problems, facial weakness, balance problem and weakness of arms and legs. Gamma Knife Surgery offers patients a non-invasive alternative for various conditions and provides new options for the patient with "inoperable" disease. It gives the affected individuals a choice and moreover, a chance for a better quality of life.
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