Radiosurgery
Why is radiosurgery done?
Stereotactic radiosurgery may be recommended as treatment for several different types of problems that might involve your brain.
- Brain tumor – a cancer arising from your brain cells or another area that then spreads to your brain. Some benign tumors may also be treated.
- Arteriovenous malformation (AVM) – an abnormal tangle of blood vessels in your brain.
- Trigeminal neuralgia, also called tic doloureux – an excruciating nerve pain involving a portion of your face that occurs in episodes.
- Acoustic neuroma, also called vestibular schwannoma – a benign tumor affecting your hearing and balance nerves on one side.
- Pituitary tumor – a gland tumor at the base of your skull that may affect hormone function or vision.
Radiosurgery shrinks or destroys a tumor by damaging the DNA in tumor cells. It can also be used to gradually close off the abnormal blood vessels in an AVM, and it can gradually injure the pain fibers in the nerve that causes trigeminal neuralgia. With stereotactic radiosurgery, the best results occur if your tumor or AVM is under a certain size.
Stereotactic radiosurgery can also be used for spine and spinal cord problems.
How is radiosurgery done?
This is not really a surgery, but a very precise form of radiation treatment. The abnormal area is outlined on a 3D image of your brain. Small beams of radiation are directed to the target from many different angles. Each beam has little effect on your normal brain tissue; however, a very high dose of radiation hits the target. This is the one spot where all the different beams intersect.
Certain stereotactic radiosurgery procedures may require the use of a reference frame placed on your skull, but many do not. Sometimes your doctors may consider treating individual portions of a larger tumor or AVM by using three to five treatments given over time.
What are my risks? What are common complications?
The chance for side effects or complications from radiosurgery is low overall. There can be some hair loss, especially if the area being treated is just under the skull. Brain swelling at the site of treatment may occur and produce symptoms. This can usually be helped by an oral corticosteroid medication. There is roughly a 3% chance you may develop permanent damage to your brain or nerves in the area of treatment. If this occurs, you may require additional therapies and you might be left with additional neurologic issues. It is possible that stereotactic radiosurgery may not be able to fully treat your problem.
What do I need to know before radiosurgery?
Radiosurgery is an outpatient procedure; however, it may take a good portion of the day, especially if a head frame needs to be used. You should not eat eight hours before the procedure. You may sip clear liquids up to two hours before surgery. Check with your healthcare provider about taking your usual medications.
Wear comfortable clothes and do not wear jewelry, makeup, contacts, wigs or hairpieces.
If a head frame is used, you may get your brain imaging studies (such as a 3D CT or MRI scan, or an angiogram ) after it is put on you. The frame is secured in place by four pins that are placed into your head after using a local anesthetic to numb the spots. For a frameless radiosurgery procedure, your imaging studies will be obtained at an earlier date.
General discharge instructions
You will have no new restrictions in your activity following radiosurgery. You may feel tired for a while, so use common sense and resume your pretreatment activity gradually. Follow the instructions given by your radiation therapy team. Contact your healthcare provider if you develop nausea, vomiting or a new seizure or headache.
What should I expect while recovering?
You may feel tired or fatigued for several weeks. Your scalp may temporarily be red, irritated or sensitive. You may have some hair loss, but usually this is temporary. Headache, nausea or vomiting may occur, but these are not common.
Radiosurgery takes time to work. Brain cancers tend to show response within months. Trigeminal neuralgia may take several weeks to months to show improvement. An acoustic neuroma may take 18 – 24 months and an AVM may take over two years.
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