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Radiosurgery is a technique in which radiation is delivered in a very focused manner to the brain. There are different ways of delivering radiosurgery (or stereotactic radiosurgery) including linear accelerators, Gamma Knife, Cyber Knife, and proton beam. In each case, the goal is to deliver a high dose to the target region while minimizing radiation doses to other parts of the brain and head. The procedure is incisionless and does not require anesthesia.

Radiosurgery is a treatment option for:

  1. Trigeminal Neuralgia – ~70% success rate
  2. Essential tremor – ~90% of patients experience an average of 50% reduction in tremor
  3. Brain tumors – ~90% control rate
  4. Arteriovenous malformations -~80% obliteration rate
  5. Pituitary tumors – response rates vary depending on tumor type

Why Undergo Radiosurgery?

Radiosurgery is a non-surgical therapy that uses a single or a few treatments to provide precisely targeted radiation at much higher doses. Neurosurgeons can use radiosurgery to reach the deepest depths of the brain and treat illnesses that aren’t treatable with traditional surgery.

Radiosurgery treatment is only possible thanks to the development of cutting-edge radiation technologies. These technologies allow for maximum dose distribution within the target while limiting exposure to healthy tissue in the surrounding area. The goal is to deliver doses that will kill the tumor and give the patient long-term local control.

How Does Radiosurgery Work?

Radiosurgery functions in a similar way to other types of radiation therapy. It does not destroy the tissue; instead, it damages the cells’ DNA. As a result, the tissue is altered. In the case of tumors, this can help control tumor growth. In the case of pain, it can prevent the tissue from transmitting the pain signal.

Benign tumors normally diminish over the course of 18 months to two years after therapy. Tumors that are malignant or metastatic may decrease more quickly, even in a matter of months.

Arteriovenous malformations (AVMs) that are treated with radiosurgery may begin to thicken and seal off over a period of several years after therapy. Many tumors will remain stable and dormant for an extended period of time.

Sometimes radiosurgery can cause a temporary growth, such as with acoustic neuromas (or vestibular scwannomas). This is a result of an inflammatory reaction within the tumor tissue. This eventually stabilizes or leads to pseudoprogression or tumor regression.

Radiosurgery Preparation

Radiosurgery is frequently done as an outpatient procedure. However, expect to spend at least a half-day at the facility. You’ll be told if you’ll need someone to accompany you and drive you home afterward. During radiosurgery of the brain or spine, avoid wearing eyeglasses, contact lenses, jewelry, cosmetics, nail polish, wigs, and dentures.

It’s possible that you’ll be told not to eat or drink anything after midnight the night before your procedure. You should consult your doctor before taking any prescriptions on the day of your procedure and carry those medications with you. You should also inform your doctor if you are using any oral diabetic medicines or insulin.

You should also mention if you have an artificial heart valve pacemaker, defibrillator, brain aneurysm clips, implanted pumps or chemotherapy ports, neurostimulators, eye or ear implants, stents, coils, or filters. It’s also crucial to reveal whether or not you have claustrophobia.

Radiosurgery Procedure

Children are frequently sedated for imaging tests and radiosurgery. Adults are normally awake, but a light sedative may be administered to aid relaxation.

During radiosurgery therapy that utilizes the Gamma Knife, the machine does not move; instead, the bed moves within the machine. Your head frame will be securely attached to the bed frame as you lie on a bed that glides into the Gamma Knife machine. The treatment can take anywhere from an hour to four hours, depending on the size and shape of the target.

In most cases, it takes less than an hour to complete the therapy. You won’t feel any radiation, and you’ll be able to communicate with the doctors through a microphone.

Radiosurgery Recovery

Bandages are applied over the pin locations from the stereotactic frame after radiosurgery, and they should be removed the next day. Patients may be monitored for a period of time after treatment before being discharged, or they may be admitted to the hospital for observation overnight.

Tenderness around the pin sites is common in certain people after radiosurgery treatment. Swelling might occur around the pin sites on occasion. If edema is not an issue, most patients can resume their normal activities the next day.

How Much Does Radiosurgery Cost?

The cost of radiosurgery is determined by the type of stereotactic radiosurgery used, as well as the type and severity of the condition being treated. MRIs, radiological interpretation, and follow-up visits will all affect the total cost.

Most health insurance plans cover stereotactic radiosurgery. Some insurance companies may refuse to cover stereotactic radiosurgery because it is experimental, depending on the ailment being treated and the type of stereotactic radiosurgery used.

Contact Us to Learn More

Contact us today and schedule a consultation with Dr. Nader Pouratian to learn more about radiosurgery in Dallas. Each case must be carefully tailored, with the patient and the neurosurgeon working closely together.

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