Gamma Knife radiosurgery

Gamma Knife radiosurgery is applicable for treating various conditions including:

• Benign and malignant brain tumors.
• Nerve disorders like trigeminal neuralgia, arteriovenous malformations (AVMs), acoustic neuroma, and pituitary tumors located at the base of the brain.

Potential risks and side effects associated with Gamma Knife radiosurgery include:

• Headaches
• Nausea and vomiting
• Brain swelling, which may manifest around 6 months post-surgery rather than immediately
• Redness and irritation of the scalp, particularly in areas where the head frame was applied during the procedure
• Numbness or tingling sensations on the scalp where surgical pins were inserted
• Hair loss if the tumor is situated close to the scalp
• Bleeding
• Seizures
• Fatigue

Gamma Knife radiosurgery typically utilizes specialized equipment and imaging scans. Usually, only sedation or local anesthesia is required. Since patients do not undergo traditional surgery, the risk of infection and bleeding is minimized.

Most patients experience minimal to no pain, although they may feel slight discomfort from the local anesthesia. Additionally, wearing a headframe to prevent head movement during the procedure may also cause some mild discomfort.

Duration: 15 minutes to 1 hour.

i) Preparations before the Procedure:

The radiosurgery procedure begins with the attachment of a lightweight frame to your head using four pins, each placed on either side of your forehead and in the back of your head. Local anesthesia is applied at the pin insertion sites to minimize discomfort. This frame serves to stabilize your head during the radiation treatment and acts as a reference for targeting the radiation beams.

You may experience some pressure for a brief period as the pins are tightened, which will persist until the frame is removed at the end of the procedure. Following this, a radiation therapist will take measurements of your head and conduct either a computerized tomography (CT) or magnetic resonance imaging (MRI) scan with the head frame in position.

If necessary, a small needle may be inserted into the back of your hand or arm to inject a dye into your blood vessels, aiding in the visualization of tumors and blood vessels during planning. Subsequently, the radiosurgery team will analyze the results of your brain scans to determine the specific areas to treat, the appropriate radiation doses, and how to precisely focus the radiation beams.

This planning phase typically takes 1 to 2 hours, during which you can relax in another room while the frame remains attached to your head.

ii) During the Procedure:

When it's time for your treatment, you'll lie on a bed that smoothly moves into a Gamma Knife machine, where the radiation is administered. Your head frame will be secured to a helmet within the machine.

During the procedure, you won't feel the radiation or hear any noise from the machine. Communication with the team is facilitated through a microphone, and they'll closely monitor you via cameras situated just outside the room.

iii) Post Procedure:

After the procedure, the table will slide out of the machine, and the radiosurgery team will re-enter the room to remove the head frame. Typically, within about 30 minutes, any pressure from the head frame should diminish.

You might notice slight bleeding and tenderness at the pin sites. Medications will be provided to alleviate potential symptoms such as headache, nausea, or vomiting post-procedure.

Following completion, you'll be observed in the monitoring area for up to an hour before being discharged.

iv) Aftercare and Recovery:

The morning after your procedure, you can remove the bandages from the pin sites. Clean them twice daily with either hydrogen peroxide or mild soap and water. Applying a small amount of antibiotic ointment to the pin sites for 3 to 4 days is also recommended. Keep the pin sites uncovered as they will heal quickly.

Wait for 24 hours before washing your hair to allow the pin sites to heal and prevent infection. If there is any bleeding, apply pressure to the area with tissue paper for 10 minutes.

Contact your doctor if you experience any of the following:

• The pin sites feel warm to the touch.
• Cloudy or foul-smelling drainage is coming from the pin sites.
• You have a fever of 38°C (100.4°F) or higher.

Seek immediate medical attention at the accident and emergency clinic if you encounter any of the following:

• Nausea
• Vomiting
• Severe headache
• Difficulty speaking
• Visual changes
• A seizure.