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Treatable Indications for Gamma Knife Surgery
- Brain tumors
- Brain metastases
- High-risk surgical patients
- An adjunctive treatment with open surgical procedures
- Trigeminal neuralgia (TGN)
- Acoustic neuroma
- Malignant glioma
- Pituitary tumors
- Arteriovenous malformations (AVM)
Brain metastasis is the spread of malignant cells from one area of the body to the brain tissue and is the most common type of brain tumor. Metastasis to the brain may originate from various primary tumor locations including lung, breast, skin, kidney, and colon. The most common source of brain metastases in males is lung cancer; in females, it is breast cancer. Metastatic tumors of the brain (“Mets”) can arise anywhere in the brain. Mets can present themselves as a single lesion (solitary metastasis) or as more than one lesion (multiple metastases). These presentations warrant different treatment regimens—Gamma Knife alone or in combination with surgery, radiation therapy, or chemotherapy.
Trigeminal neuralgia is a disease of the facial nerves that causes the sudden onset of face pain. This pain may come and go, with no treatment necessary. If treatment is necessary, medication may successfully control the pain. Unfortunately, sometimes the pain will become worse and cease to be controlled with medication. The Gamma Knife is a superb non-surgical option to treat this pain with excellent to good pain relief.
An acoustic neuroma is a skull-based tumor that affects the sheath of the VIII cranial nerve. In general, this is a slow-growing, benign tumor. Although it is a benign tumor, this tumor presses on the nerves associated with hearing and balance. The preservation of hearing is critical in the treatment of this disease.
Gliomas are tumors that arise in the brain tissue itself, glial tissue (as opposed to metastatic brain tumors which arise from other body organs and travel to the brain). They are the most common type of brain tumor. There are several different types of gliomas: astrocytomas, oligodendrogliomas, ependymomas and glioblastoma multiforme. Gliomas are identified by their microscopic appearance and are graded based on their level of malignancy. As the grade of the tumor increases, the tumor becomes more aggressive. Grade I: Pilocytic Astrocytoma, which is considered benign. Grade II: Low-Grade Astrocytomas, which includes most oligodendrogliomas and ependymomas and are often mixed, hence mixed glioma. Malignant or benign tumors may be considered. Grade III: Anaplastic Astrocytoma may be a reoccurrence of a lower grade, previously treated tumor. Grade IV: Glioblastoma Multiforme, which is the most malignant form of astrocytomas. Each grade of tumor can be treated with the Gamma Knife.
Meningiomas are tumors that arise from the leptomeninges or the brain-lining tissue. Meningiomas are slow growing and, in general, are benign tumors. Treatment for meningiomas may include surgery, Gamma Knife, or both.
The pituitary gland is also referred to as the “master” gland. This reference is made because the pituitary gland is responsible for regulating many functions performed by the other organs in the body. The pituitary gland will secrete hormones that communicate these functions to the organs. The gland is divided into two parts: the anterior pituitary and the posterior pituitary. Therefore, tumors of the pituitary gland can affect the entire body.
Arteriovenous malformations (AVMs) usually develop during the developmental stages of a fetus but usually do not pose any problems until the person approaches their 20s or 30s. An arteriovenous malformation is an incorrectly formed group of blood vessels in the brain. This malformation causes the blood flow to cease and form pockets of blood. These pockets, or “nidus,” may enlarge over time and cause the patient difficulties, such as a severe headache, seizure, or stroke. There is also the possibility that these pockets will rupture. Treatment of AVMs is used to reduce this risk of rupture and reduce the potential side effects from the rupture or the enlargement of the vessels.
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