Neurosurgery Without Craniotomy
January / February 2006
Pennsylvania Hospital offers Gamma Knife surgery as option
to patients.
Gamma Knife® radiosurgery revolutionized
neurosurgical options for patients. Prior to Gamma Knife,
neurological treatment options were often limited to either
open surgery or radiation to the entire brain — both
of which could damage nearby healthy tissues. Further, some
lesions that were previously considered inoperable due to
location within the brain may often be treatable by Gamma
Knife. With its pinpoint accuracy, low risk and history of
successful outcomes, Gamma Knife is a significant advancement
in the field.
Although treatment options
vary based on the individual patient case, Gamma Knife radiosurgery
may be the preferred treatment for many brain tumors as well
as other diseases of the brain, including:
- Brain metastasis – tumors
that originate outside the brain but then spread to the
brain.
- Primary brain tumors – meningiomas, astrocytomas,
craniopharyngiomas, hemangioblastomas.
- Acoustic neuromas – Benign
tumors that develop on the nerve that impacts balance and
hearing.
- Pituitary tumors – Tumors that can cause hormonal
imbalance, growth problems and loss of vision.
- Arteriovenous
malformations (AVMs) – AVMs are abnormal collections of blood
vessels and can cause severe bleeding, headaches or seizures.
- Trigeminal
neuralgia – A nerve disorder causing extreme facial pain.
Gamma Knife surgery targets 201 beams of radiation on one
intracranial target. The beams originate from different locations
around the skull and are programmed to target the lesion
at the point where they intersect, limiting radiation exposure
to surrounding tissues. “Gamma Knife is a very precise
and powerful method to functionally destroy a lesion. In
addition, it has a proven track record,” says John
Y.K. Lee, MD, medical director of the University of Pennsylvania
Health System’s Gamma Knife surgery program. “Over
time, many lesions decrease in size and dissolve.”
Patients find this approach to be much more tolerable than
traditional open surgery. They typically experience little
discomfort. A local anesthetic is used to alleviate discomfort
while the head frame is attached to the skull. In the majority
of cases, the patient goes home after the procedure. No long
hospitalization or rehabilitation is required. “Gamma
Knife is a safe, proven and effective
alternative to surgery and whole brain radiation,” says
Peter
LeRoux, MD, vice chair, Department of Neurosurgery
at the Hospital of the University of Pennsylvania. “Patients
appreciate the noninvasive approach.”
The technique is a good treatment option for most patients,
although the size and location of the lesion as well as patient
choice will ultimately determine which approach is best. “In
general, Gamma Knife surgery is best suited for tumors or
other lesions such as AVMs smaller than 3 to 4 centimeters,” says
Dr. Lee. “It may not be as advantageous with larger
tumors but can be used in combination with open surgery to
successfully treat residual tumor or AVM.” Dr. LeRoux
agrees. “If the lesion isn’t small enough for
Gamma Knife, it may make sense in some patients to remove
80 percent of it with standard surgery and treat the remaining
20 percent with Gamma Knife surgery.”
At Pennsylvania Hospital, the advantages of Gamma Knife
surgery include a robotic attachment for the Gamma Knife
machine, which allows the robot to position the patient’s
head with precision not easily achieved without it. This
robot reduces human error while maintaining the traditional
advantages of Gamma Knife surgery-precision and power. “A
Gamma Knife surgery program is only as successful as the
neurosurgeons, radiation oncologists, radiation physicists
and staff who are involved in it,” says Dr. LeRoux. “We
have an excellent multidisciplinary staff who work together
to provide patients with the best possible treatments.”
For more information, please visit the Penn
Gamma Knife Center web site.
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Referring Physicians: To speak with a Penn physician
or refer a patient, contact PennHealth through the secure online
referral form or by calling
1-800-789-PENN
(7366). |
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