Frequently Asked Questions
Read the answers
to the questions most frequently asked by our
Penn Gamma Knife® Center
at Pennsylvania Hospital patients:
Do you have a question that is not listed here?
Ask
your questions to Dr. John Y.K. Lee and view
more responses.
What is Gamma Knife radiosurgery?
Gamma Knife radiosurgery is a precise and powerful
treatment for brain disorders. It is noninvasive,
effective and
safe. This makes it the optimal choice for treating
a wide
variety of conditions including benign or malignant
brain
tumors, blood vessel malformations, trigeminal
neuralgia
(also called tic douloureux) and tremor.
There
are other benefits to Gamma Knife radiosurgery.
Pre-treatment preparation and the actual radiosurgery
are
performed in one day. Most patients can return
to their
normal routines in a day or so. In addition,
radiosurgery is
less expensive than conventional neurosurgery.
It eliminates
the need for lengthy hospitalization, medications
and
rehabilitation.
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Is Gamma Knife radiosurgery right for me?
Gamma Knife radiosurgery can successfully treat
patients
with the following disorders:
- Brain Tumors
- Brain metastasis from other
parts of the body
(e.g. lung, breast, melanoma)
- Acoustic
neuroma/vestibular schwannoma (benign tumor
on nerve leading to inner ear)
- Meningioma
(benign tumor of protective membranes
around brain and spinal cord)
- Pituitary
adenoma (benign tumor of the hormonesecreting
pituitary gland)
- Glioma/astrocytoma (malignant
brain tumor)
- Chordoma (benign tumor at
base of the skull or lower
spine)
- Craniopharyngioma (benign tumor
at base of the skull)
- Hemangioblastoma
(benign tumor of nervous system)
- Vascular
Disorders of the Brain
- Arteriovenous
malformations (AVM) (a thick bundle of
arteries and veins)
- Arteriovenous fistulas
(AVF) (abnormal communication
between artery and vein)
- Cavernous malformations
(cluster of abnormal blood
vessels)
- Q: Other
Disorders
- Trigeminal neuralgia/Tic douloureux
(painful
condition of the face)
- Epilepsy (condition
that involves repeated seizures)
- Tremor
(severe disabling tremor from essential
tremor
or Parkinson's disease)
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Is Gamma Knife radiosurgery
safe?
More than 30,000 patients safely
undergo Gamma Knife
radiosurgery each year. The method has
been used
worldwide since 1968. Gamma Knife
radiosurgery allows
patients to quickly return to their normal
routines. In
most cases, only a single procedure is
necessary.
Our experienced Pennsylvania Hospital
Gamma Knife
team provides patients with maximum safety
and
efficacy. Skilled pre-treatment planning
and the
radiation's focused delivery
method lead to improved
patient outcomes, enhanced
quality-of-life and virtually
nonexistent damage to healthy brain tissue.
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How
does the Gamma Knife work?
Strictly speaking, the Gamma Knife is not
a knife. It is a
method of radiosurgery that
delivers extremely focused
beams of cobalt radiation to precise targets
in the brain –
as many as 201 individual beams.
Individually, the beams
are too weak to damage healthy tissue.
Together, they
converge to deliver powerful treatment
to a single point.
Another term for this type
of noninvasive neurosurgery is "stereotactic"
radiosurgery. This refers to directing
radiation to a specific
focal point using an
external, three-dimensional
frame of reference -- such as the head
frame
used in Gamma Knife radiosurgery.
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What can I expect
before my procedure?
Your physician and our Gamma
Knife team members
will discuss the radiosurgery with you
before the
procedure takes place. Since Gamma
Knife radiosurgery
is noninvasive, it is not necessary to
shave or cut your
hair.
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What can I expect during the procedure?
Gamma Knife radiosurgery planning and
treatment are
performed on the same day. Treatment
includes three
phases: fitting the head frame, procedure
planning and
actual procedure.
Fitting the head frame
One of the key components
in Gamma Knife radiosurgery
is what is called the stereotactic head
frame. The frame
allows the physician to accurately pinpoint
the area within
your brain that will be treated. The
frame is lightweight
and attaches to the head with four screws,
which ensures
that the radiation beams are precisely
directed to the target.
In addition, the frame prevents the head
from moving
during imaging and treatment. A local
anesthetic will be
applied where the screws are to be attached.
Once
the head frame is in place, images will be
taken of your brain. This imaging may include
magnetic resonance
imaging (MRI), computed tomography (CT)
or
angiography. Imaging will determine the
exact size, shape
and position of the target within your
brain.
Radiosurgical
planning
The next stage is radiosurgical planning.
Once the images
have been taken, you are allowed to rest
while the Gamma
Knife physicians develop a precise radiosurgical
plan. The
plan is made using a specially designed
computer that helps
calculate how the radiosurgical procedure
should be
performed. This generally takes one to
two hours. During
this time you can rest, watch television,
read and use the
restroom. The stereotactic head frame
will remain attached.
The radiosurgical procedure
Once the radiosurgical plan is completed,
the actual
radiosurgical procedure can begin. You
will lie down on the
procedure couch and the head frame will
be attached to a
helmet. You will be awake throughout
and will be able to
communicate with the Gamma Knife team
through an
audio and video connection. We will be
monitoring you at
all times. The procedure is silent and
painless.
The procedure time will last a few minutes
to more than an
hour, depending on the size and shape
of the targeted area.
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What can I expect after
my procedure is
complete?
Most patients should be able to return
to their normal
routines within a day or so. Some patients
may be
required to lie quietly for several hours
after treatment or
stay overnight for observation.
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What follow-up
care is necessary?
Follow-up is key when you've
had Gamma Knife
radiosurgery. That is because
the effects of the
radiosurgery occur over a period of weeks
or months.
Treatment is designed to stop the growth
of tumors or
lesions over a period of time. It is
important that you
stay in contact with your physician to
determine progress
of your treatment. This may involve follow-up
imaging
such as MRI, CT or angiography.
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Are there any
side effects?
Some patients may experience a mild headache
or minor
swelling where the head frame was attached.
Your
doctor will discuss any potential side
effects.
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Who will be involved in my procedure?
The Gamma
Knife team at Pennsylvania Hospital brings
the expertise and resources of the
region's
top
neurosurgery team.
Our Gamma Knife Team
Pennsylvania Hospital's multidisciplinary
Gamma Knife
Center team includes
expert neurosurgeons,
neuroradiologists, otorhinolaryngologists,
physicists,
radiation oncologists and specialized nurses
and
technicians. The team
works together to develop
and
execute optimal treatment for each patient.
Crucial
follow-up care is provided by
team members working
closely with your own physician.
Is Gamma Knife radiosurgery covered by
insurance?
Radiosurgery typically is reimbursed
by most insurance
companies, PPOs, HMOs and Medicare when
indicated.
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Gamma Knife and Leksell Gamma
Knife are U.S. federally registered trademarks
of Elekta Instrument S.A., Geneva, Switzerland.
Photo credits: Susan Pardys, Elekta, Inc.
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