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"Knifeless" Neurosurgery Offers Speedy Recovery
from Wake Forest University Baptist Medical Center's BestHealth February 2000
HTML editor, Stephen B. Tatter, M.D., Ph.D.
"Knifeless" Neurosurgery Offers Speedy Recovery
Shelda Edwards, a nurse from Greensboro, N.C., has a unique perspective on neurosurgery.
When she was diagnosed with a malignant brain tumor in 1981, she had traditional open surgery. Her tumor was successfully removed, but Edwards spent eight days in the hospital, followed by three months of radiation therapy. It was a year before she felt as good as she had before surgery and radiation.
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North Carolina's first Gamma Knife Radiosurgical Unit at Wake Forest University Baptist Medical Center, is a center of hope for patients with inoperable brain tumors, tremor, vascular malformations of the brain, and trigeminal neuralgia. |
When a meningioma (a slow-growing and, in this case, non-malignant tumor) developed in Edwards’ brain years later, gamma knife radiosurgery offered a new "knifeless" option – with a much speedier recovery.
Edwards was among the first patients to have the procedure at Wake Forest University Baptist Medical Center, home to North Carolina’s first gamma knife unit. Admitted for outpatient surgery last September, she had magnetic resonance imaging to pinpoint the tumor’s exact location and size, followed by the gamma knife procedure. Discharged that afternoon, Edwards was amazed at how well she felt.
The next day she was back to her normal routine.
Gamma knife radiosurgery has become the treatment of choice for selected brain tumors and vascular malformations as an alternative to conventional open surgery.
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Drs. Stephen Tatter and Edward Shaw prepare a patient for Gamma Knife radiosurgery. |
The 22-ton unit aims 201 "pencil beams" of radioactive cobalt-60 at the target brain tissue, sharply focused to minimize radiation effects to surrounding healthy brain tissues. Using computers, a team of neurosurgeons, radiation oncologists and radiation physicists precisely conform the radiation dose to the size and shape of the lesion.
While traditional surgery may deliver more immediate results, the gamma knife’s long-term prognosis is often comparable or better. In most cases, gamma knife radiosurgery immediately stops the growth of tumors, which shrink or disappear over a period of time.
Gamma knife treatment offers some patients the ability to maintain or improve quality of life, says neurosurgeon Charles Branch, M.D. "People with lesions that were considered inoperable or with health issues that made them poor candidates for open surgery are good candidates for this procedure. It is especially useful when conventional surgical techniques would pose a high risk, such as in the presence of other illnesses or when a patient’s age prohibits standard surgery."
Radiation oncologist Edward Shaw, M.D., co-director of the Gamma Knife Program, calls gamma knife "one of the most exciting and potentially beneficial medical technologies available today."
For Shelda Edwards, the experience has been overwhelmingly positive. "With my personal history and nursing background, plus having worked with brain tumor patients, I was so excited that this non-invasive technology was available for me."
A Brief History
The first gamma knife radiosurgery unit was developed in Sweden in 1967 to treat functional neurological disorders such as Parkinson’s disease, trigeminal neuralgia (severe facial pain) and essential tremor. The technology has been refined and perfected over three decades. Gamma knife radiosurgery is now an approved treatment for selected benign and malignant brain tumors and vascular malformations.
Some of the most common indications for Gamma Knife treatment include:
- Brain arteriovenous malformations (AVM)
- Benign brain tumors including acoustic neuromas, meningiomas, and pituitary tumors
- Malignant brain tumors including high-grade and selected low-grade astrocytomas
- Brain metastases
- Malignant skull base tumors
- Trigeminal neuralgia
- Essential tremor and Parkinson's disease