What to Expect

Gamma Knife Surgery (GKS) is a safe, effective and well-established procedure that allows a surgeon to perform brain surgery without actually entering the skull. Despite the name, Gamma Knife Surgery does not involve use of a knife or scalpel at all. There is no incision. Instead, this form of surgery – also known as radiosurgery – uses highly focused beams of radiation to treat precisely targeted areas of the brain. The shape and dose of the radiation is optimized to hit only the target, without damaging surrounding healthy tissue.
The procedure is simple, painless and straightforward, and it offers treatment for more than 30,000 patients every year. The practical advantages are many, including:

· Treatment is performed in a single sitting
· There is no cutting or shaving of the patient’s hair
· Hospital stays are shorter and require less recovery time than traditional surgery
· Gamma surgery avoids many of the risks of open surgery such as hemorrhage, infection, and cerebral spinal fluid leak
· The optimized radiation dose minimizes the risk of damage to the brain and thereby preserves normal brain function

Videos

Learn more about what to expect the day of your Gamma Knife surgery with these videos:

Gamma Knife Surgery Video Introduction
Gamma Knife Surgery Treatment Detail Video
Gamma Knife Surgery Video Summary

The Treatment Procedure

Before treatment your doctor will inform you about the entire procedure, which includes the following four components:

1. The head frame. The lightweight stereotactic head frame allows the doctor to accurately pinpoint the target area to be treated. It also prevents your head from moving during imaging and treatment procedures. The frame is attached to your head with four screws, and local anesthetic is applied where the screws are to be attached.

2. Imaging. After the head frame is in place, it is time for imaging to be done, such as magnetic resonance imaging (MRI), computed tomography (CT) or angiography. Imaging is required to determine the exact size, shape and position of the target in the brain. During imaging, a coordinate box is placed on the head frame to provide reference points on the images for the treatment plan. After imaging, the coordinate box is removed.

3. Treatment planning. Once your images have been taken, you can rest while your physician develops a precise and accurate treatment plan. No two treatment plans are alike; every patient’s plan is individually designed to address the specific medical condition. The doctor, very often together with another team specialist, enters the imaging data and other information into a computer and calculates how the treatment should be performed.

4. Treatment. Once your treatment plan is completed, the actual treatment can start. You will lie down on the treatment couch, and the head frame will be attached to the helmet. You are awake during the procedure and will be able to communicate with your doctor or nurse through an audio-video connection. When the treatment begins, the couch will move into the dome section of the unit. The treatment is silent and comfortable. You will be able to listen to music during the treatment. The team will be monitoring the procedure at all times. The treatment will last a few minutes to more than an hour, depending on the size and shape of the target. 

After the Treatment

When your treatment is complete, the head frame will be removed. If you had an angiogram, you might have to lie quietly for several more hours. Some patients experience a mild headache or minor swelling where the head frame was attached, but most report no problems. We can give you pain relievers to relieve these symptoms if they occur. Your doctor will tell you whether he wants you to stay overnight for observation or if you can go home immediately. Either way, you should be able to return to your normal routines in another day or so.

Follow-up

The effects of your treatment will occur over time. Radiation treatments are designed to stop the growth of tumors or lesions, which means that the effect will be seen over a period of weeks or months. Your doctor will stay in contact with you to assess your progress, which may include follow-up MRI, CT or angiography images. These follow-up images may be taken here at UVA or at a center close to your home. Either way, your doctor will provide you with complete instructions on what you need to do.