Stereotactic Radiosurgery Abroad

What is Stereotactic Radiosurgery?
Stereotactic radiosurgery is a type of radiation treatment that uses high-powered x-rays focused on a specific part of the head.

Stereotactic radiosurgery does not involve surgery but it is a form of radiation therapy used as a treatment for brain tumors, eye tumors, and various malformations and disorders in the brain. A three-dimensional system is used to target the beams to the specific location that needs radiation therapy. It is mostly done on the head and neck. The extreme energy of the radiation kills the targeted cells. Since it focuses only on the target location, the surrounding tissues are not harmed by the radiation. Stereotactic radiosurgery can access tumors and malformations that cannot be accessed by open-skull surgery.

Stereotactic radiosurgery are mostly done using the Gamma Knife machine and by using a linear accelerator machine. Gamma Knife is a static machine used mostly on tumors and blood vessels. It can deliver a very accurate radiation to the target. Stereotactic radiosurgery using a movable linear accelerator machine is used in the case of large tumors. In this type of procedure, several doses of radiation may need to be delivered to the patient over many weeks.

How is Stereotactic Radiosurgery Performed?
During stereotactic radiosurgery, the patient needs to lie down on a table. The table glides into a machine that gives out radiation beams. The patient usually has a head frame attached to the scalp to keep the patient still through out the procedure. The frame may be fixed with pins or anchors that are attached to the skin but not to the skull bone. A particular plastic mask may also be fitted to the patient’s face.

An MRI or CT scan is first done to determine the particular area for treatment.

During the radiation treatment, the patient will be visible to the doctors and other medical staff. The patient will also be able to talk with the doctors with the aid of microphones.

Once the procedure ends, the head frame is removed.

How to Prepare for Stereotactic Radiosurgery?

• The patient will have MRI or CT scan.
• The patient should not use hair creams or sprays.
• Jewelry and other accessories worn by the patient needs to be removed before the procedure.
• An intravenous tube may be fitted to the patient’s arm to provide contrast material during the procedure.
• The patient may be given a sedative or anti-nausea agent before the procedure.

Duration of procedure/surgery:
Approximately 1 to 2 hours

Days admitted:
Stereotactic radiosurgery is usually done as an outpatient procedure and may require a total stay in the hospital for approximately 12 hours. Some patients may need to be monitored and may have to stay overnight in the hospital.

Anesthesia:
Local anesthesia is used to attach the frame on the patient’s head. Sedatives may be provided to some patients during the procedure.

Recovery:
- The head frame is removed after the procedure. During the removal, the patient may have some bleeding from the pinned site.
- The patient may be able to return home around an hour after the treatment.
- Some patients may need to be monitored and may have to stay overnight in the hospital.
- Some patients may need up to five treatment sessions.

Risks:
- Damage to the surrounding tissue
- Brain swelling
- Headache
- Itchy and sensitive skin on the area of treatment
- Hair loss
- Nausea and vomiting
- Difficulty in eating and swallowing
- Diarrhea
- Fatigue

After care:
- The patient should not drive home after the procedure. Arrangements should be made for someone to drive the patient home.
- The patient should consult the doctor about any side effects experienced after the procedure.