Brain Surgery Without an Incision

GAMMA_KNIFE-2-211x300The Gamma Knife is an advanced tool for the treatment of benign and malignant tumors, arteriovenous malformations (AVMs), facial pain, and other functional brain disorders.

It is not actually a knife, but a 20-ton medical instrument that emits 201 finely focused beams of gamma radiation. These beams simultaneously intersect at the precise location of the brain disorder and treat it with minimal effect on surrounding normal tissue – without the risks of surgery or an incision.

WVU Medicine’s Gamma Knife has greatly increased our ability to provide the full range of advanced neurosurgical care to patients. Gamma Knife radiosurgery maximizes patient comfort and can treat lesions that were previously inaccessible or treated unsuccessfully by conventional surgery, chemotherapy, or radiation therapy.

Benefits to Patients

  • No surgical complications – The risks of surgery, such as infection, hemorrhage, or leakage of cerebral spinal fluid, are nonexistent.
  • No general anesthesia – The procedure is performed with only local anesthesia and mild sedation, eliminating the side effects and risks of general anesthesia.
  • Highly targeted treatment – Gamma Knife radiosurgery affects only the diseased areas of the brain, sparing unnecessary radiation of adjacent, normal brain tissue.
  • One-day treatment – Gamma Knife radiosurgery is a one-day treatment compared to other treatments that must be repeated several times. It can be repeated if necessary.
  • Cost effective – Gamma Knife radiosurgery is much less expensive than traditional brain surgery. Patients are usually able to leave the hospital within a day and resume normal activities immediately. Post-surgical disability and convalescent cost are nonexistent.
  • Patient- friendly – Since the Gamma Knife is minimally invasive, patients experience virtually no discomfort. Most patients are treated on an outpatient basis.
  • Excellent success rate – After two decades of research, no other neurosurgical tool has shown results as impressive as the Gamma Knife. After treatment, most brain tumors disappear or stop growing over time. Usually, after one year, 40 percent of AVMs are cured, increasing to 80 percent two years after treatment. More than 150,000 patients have had Gamma Knife radiosurgery. The Gamma Knife’s many benefits often make it a treatment of choice.

Gamma Knife radiosurgery offers greatly reduced risks and equal or greater benefits compared to traditional neurosurgery or radiation therapy.

On the day of the treatment, a lightweight frame is attached to the patient’s head. With the frame in place, the patient has an MRI, CT, or angiography to precisely locate the diseased area to be treated.

A series of images is taken and transferred to the computerized treatment planning system. The system localizes the target, determines its coordinates, and ensures that the radiation field conforms precisely to the target.

The Gamma Knife is then used to direct multiple beams of ionizing gamma radiation from 201 separate cobalt sources to the targeted area within the brain.

Intersecting at the target, the concentrated rays eradicate the tumor or vascular abnormalities, while surrounding tissues receive minimal radiation exposure. Treatment sessions typically last 40 to 60 minutes. Patients usually return to normal activities the same day or the following day.

  1. When you arrive at Ruby Memorial Hospital, register on the first floor. You will be directed to 2 West, outpatient surgery.
  2. A nurse will take you to the preparation area where an intravenous line (IV) will be started.
  3. Head Frame Placement – Medication may be given to relax you. The doctor will place the head frame, which takes 10 to 15 minutes. The frame allows the doctor to plan the treatment and position your head for the actual treatment. The frame is aluminum and weighs less than two pounds. You will wear it all day.The frame will be attached to your head with four pins, two on your forehead and two on the back of your head. You will receive numbing medication at the pin sites.
  4. After the frame is placed, we will take MRI, CT, or other images of your head and brain that are needed for precise planning of your treatment.
  5. Treatment planning may take up to two hours. During this time you may rejoin your friends or family members, and you may be permitted to eat or drink. The head frame must remain attached, but you should not feel discomfort.
  6. Once your treatment plan is complete, you will be taken back to the Radiation Therapy suite and placed on the Gamma Knife couch. Your head, with frame attached, will be positioned precisely according to predetermined target coordinates. During your treatment, the medical team will be in another room. You will be watched through closed-circuit TV, and a microphone near your head will enable you to communicate with the team. The treatment usually lasts one to two hours.
  7. After your treatment, the head frame will be removed, and the pin sites will be cleaned and covered with band-aids. You will be monitored for approximately an hour before going home. You will receive specific instructions concerning follow-up care. With the Gamma Knife, serious side effects or complications can occur but are very rare. They will be explained to you prior to your procedure.

Preparing for Your Gamma Knife Radiosurgery:

  • Shampoo your hair the evening before your appointment. Do not use hair products such as hairspray, styling gel, etc., after shampooing. Also, do not use these products the morning of your procedure.
  • Do not wear any makeup on the day of your procedure, as it would interfere with frame placement.
  • Take your medications as usual before your procedure, unless otherwise instructed. Bring any medications you take with you to the hospital.
  • gamma-knife-prepareOn the day of your procedure, wear comfortable clothing, including a shirt that buttons up the front. Because metal is not allowed near the scanning equipment, you may not wear anything with metal parts, such as metal buttons or zippers. Sweat pants or pajama pants with a drawstring are good choices as long as they contain no metal parts.
  • You may wear dentures, partial plates, hearing aids, contact lenses, and/or glasses to the hospital, but you will be asked to remove them prior to frame placement.
  • You may bring books, magazines, videos, etc., to help pass the time during treatment planning, and you may bring CDs or an iPod to listen to during your treatment.
  • Have a friend or family member stay with you and be available to drive you home.

If you have any concerns or questions after returning home, call 304-598-4707.

Sanjay Bhatia, MBBS, MD, FAANS

Associate Professor
J.W. Ruby Memorial Hospital
View Profile304-598-4820

Christopher Cifarelli, MD, PhD, FAANS, FACS

Director, Gamma Knife Program; Assistant Professor
J.W. Ruby Memorial Hospital, United Hospital Center
View Profile304-598-4820

Geraldine Jacobson, MD, MPH, MBA

Chair/Professor, Radiation Oncology
J.W. Ruby Memorial Hospital
View Profile304-598-4000

Malcolm Mattes, MD

Radiation Oncologist, Assistant Professor
J.W. Ruby Memorial Hospital
View Profile304-366-9999

Camden Clark Radiation Oncology

705 Garfield Avenue
Parkersburg, WV 26101

J.W. Ruby Memorial Hospital

1 Medical Center Drive
Morgantown, WV 26506