Gamma Knife Radiosurgery: Procedure, Recovery, Cost, Risk & Complication

Gamma knife radiosurgery is a radiation therapy which uses highly-focused gamma rays to treat tumors, lesions, vascular malformations and other brain abnormalities. It also treats several neurological conditions such as acoustic neuroma and trigeminal neuralgia.

A gamma knife aims beams of gamma rays through a target point in the patient’s brain. The patient is asked to wear a specialised helmet that is fixed to their skull surgically, to ensure no movement of the brain tumour from the target point of gamma rays. It spares the other cells and only aims at the tumor cells of the brain. It helps to destroy the DNA of these cells making them unable to reproduce or grow.

Gamma knife radiosurgery would be recommended to you if :

• You have a tumor previously deemed inoperable due to its location.
• You have a medical condition that increases risk for conventional surgery.
• You have a tumor that is recurrent after radiation therapy or surgery.
• Your tumor was not totally removed by surgery.
• You are suffering from brain tumors, brain cancer, any blood vessel defects, trigeminal neuralgia and acoustic neuroma.

Pre Procedure

You have to follow these pre-procedures before undergoing a gamma knife radiosurgery :

• You will be asked to sign a form of consent that permits the doctors to do the procedure.
• You have to undergo blood tests or other diagnostic tests to ensue that you are in good health before starting the procedure.
• Women of child bearing age may need to give a urine specimen for pregnancy tests.
• You have to fast for 8 hours before the procedure.
• You may have to wash your hair with a specially prescribed shampoo the night before the procedure.
• You may be given a sedative to help you relax.
• You will have to shave the area around the head frame insertion sites.

Based on your medical condition your doctor may request other preparations before undergoing the procedure.

During Procedure

The gamma knife radiosurgery may take less than an hour to about four hours, depending on your medical condition, the size and shape of the target. It starts off with you resting on a bed that slides into the gamma knife device and your head frame being attached to the helmet in it. After the attachment of the head frame you will undergo brain brain imaging to locate the tumor precisely. You will have an intravenous (IV) tube, most likely in your arm, to deliver fluids and medications to your bloodstream during the process.

During the procedure you may not be able to feel or hear anything from the gamma knife unit. You will have an intercom available to help you communicate with the doctors. They will observe you with the help of a video monitor. After the procedure, the head frame will be removed, pin insertion sites will be cleaned, sterile dressing will be applied and you will be free to go at the end of the day. In some cases, an overnight stay is recommended to the patient.

Post Procedure

After the procedure is complete you will be under observation for a period of time. You will need to lie there until no more bleeding takes place. You will be able to eat solid food and take liquids orally as tolerated after the IV tube is removed. You may experience headache, nausea and other forms of discomfort for which you will be advised to avoid any strenuous activities for a certain period of time. The patient undergoing gamma knife radiosurgery is usually released at the end of the day or asked to stay overnight. Most likely, you will also be asked to shampoo your hair the day after the procedure. You will be advised to not disturb or scrub the pin sites on your head until they are completely healed which takes about a week or so. Your doctor may advice you to carry out additional procedures depending on your medical situation.

Some side effects of gamma knife radio surgery includes swelling of the brain, nausea, numbness and headache. Some other risks and side effects may depend on the location and size of the target area. These may include hair loss near treated area, seizures, weakness, loss of balance and vision problems. Radiation exposure due to gamma knife radio surgery during pregnancy may lead to birth defects. Possible complications include edema and injury to surrounding areas in the brain. The risks of traditional brain surgery, such as infection, hemorrhage and stroke are avoided with gamma knife radiosurgery. There may be other risks and complications depending upon your medical condition. Be sure to discuss any concerns with your doctor before the start of the treatment.

Once the gamma knife treatment is done, you can go back to your normal diet, medications, and activities unless your doctor instructs you differently. You will be advised to avoid strenuous activities like exercise for a specific period of time. You will also be advised to not scrub the pin sites on your head until about the week or so. Consult your doctor immediately if there are severe signs of side effects.

The cost of gamma knife radiosurgery vary as per diagnosis, medical condition and facilities availed by the patients.