Type of Surgery
Last updated: 02/17/2009
"Radiosurgery" refers to the use of a high-energy beam of radiation. "Stereotactic" refers to the three-dimensional targeting system used to deliver the beam to the precise location desired. Stereotactic radiosurgery is primarily confined to the head...
and neck, because the patient must be kept completely still during the delivery of the radiation in order to prevent damage to surrounding tissue. The motion of the patient's head and neck are restricted by a stereotactic frame that holds them in place. It is difficult to immobilize other body regions in this way.
The high energy of the radiation beam disrupts the DNA of the targeted cells, killing them. Multiple weak beams are focused on the target area, delivering maximum energy to it while keeping surrounding tissue safe. Since the radiation passes through the skull to its target, there is no need to cut open the skull to perform the surgery. The beam can be focused on any structure in the brain, allowing access to tumors or malformed blood vessels that cannot be reached by open-skull surgery.
Two major forms of stereotactic radiosurgery are in use as of 2003. The Gamma KnifeÂ® is a stationary machine that is most useful for small tumors, blood vessels, or similar targets. Because it does not move, it can deliver a small, highly localized and precise beam of radiation. Gamma knife treatment is done all at once in a single hospital stay. The second type of radiosurgery uses a movable linear accelerator-based machine that is preferred for larger tumors. This treatment is delivered in several small doses given over several weeks. Radiosurgery that is performed with divided doses is known as fractionated radiosurgery. The total dose of radiation is higher with a linear accelerator-based machine than with gamma knife treatment.
Disorders treated by stereotactic radiosurgery include:
- benign brain tumors, including acoustic neuromas and meningiomas
- malignant brain tumors, including gliomas and astrocytomas
- metastatic brain tumors
- trigeminal neuralgia
- Parkinson's disease
- essential tremor
- arteriovenous malformations
- pituitary tumors
Radiosurgery, also known as stereotactic radiotherapy, is a medical procedure which allows non-invasive treatment of benign and malignant conditions, arteriovenous malformations (AVM's), and some functional disorders by means of directed beams of ionizing radiation. It is a relatively recent technique (1951), which is used to ablate, by means of a precise dosage of radiation, intracranial and extracranial tumors and other lesions that could be otherwise inaccessible or inadequate for open surgery. There are many nervous diseases for which conventional surgical treatment is difficult or has many deleterious consequences for the patient, due to arteries, nerves, and other vital structures being damaged.
Select comparative data from 1999 to 2006 include an 11 percent increase in the number of neurosurgeons with full-time academic appointments and a 6 percent increase in the number of female neurosurgeons.
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