Preoperative radiological examinations such as CT-scan, MR-scan,
conventional x-rays and/or angiography are necessary for identifying
the exact area to be treated. For the treatment, the entire
hospitalisation period is 36 - 48 hours.
The actual procedure is 4 - 8 hours. Incisions or general
anaesthesia are not required. The patient remains conscious
throughout the procedure and may communicate with the surgical
team. Normally the patient can return to preoperative lifestyle
the following day.
Follow-up is done at an interval of 3, 6, 12, 18 or 24 months.
Procedure
1. Frame Fixation
During
frame fixation, a metal stereotactic frame is fixed on thepatient's
head by the neurosurgeon using local anesthesia. The frame
acts as a reference point for the subsequent calculation of
target coordinates in the brain using neuroradiological images.
2. Diagnostic Imaging
After frame fixation, the patient then undergoes a head scan
(magnetic resonance imaging scan or a computerized tomography
scan). An angiogram is required for patients with arterio-venous
malformation.
The imaging is carried out at the NMC Imaging and Diagnostic
Centre which is conveniently attached to the Gamma Knife Centre.
It is equipped with MRI, Whole Body CT Scan, C-Arm with DSA,
Ultrasound, EEG, EMG with back-up of the most modern computerised
pathology and clinical chemistry laboratory. The Centre is
recognized for its prompt and excellent reporting systems.
3. Treatment Planning
During
treatment planning, the diagnostic images (CT, MRI etc.) are
used to accurately compute the radiation dose with the help
of a powerful computer workstation and software (Leksell Gamma
Plan).
4. Actual Treatment
The
Gamma Knife couch moves the patient head-first into a heavily
shielded helmet which contains radioactive cobalt sources
and the predetermined radiation doses are administered to
the target. Actual treatment typically lasts 5 to 20 minutes,
but may extend to 1 or 2 hours, depending on the volume and
location of the targets.
Patient
Resources 
During
frame fixation, a metal stereotactic frame is fixed on thepatient's
head by the neurosurgeon using local anesthesia. The frame
acts as a reference point for the subsequent calculation of
target coordinates in the brain using neuroradiological images.
During
treatment planning, the diagnostic images (CT, MRI etc.) are
used to accurately compute the radiation dose with the help
of a powerful computer workstation and software (Leksell Gamma
Plan). 
The
Gamma Knife couch moves the patient head-first into a heavily
shielded helmet which contains radioactive cobalt sources
and the predetermined radiation doses are administered to
the target. Actual treatment typically lasts 5 to 20 minutes,
but may extend to 1 or 2 hours, depending on the volume and
location of the targets.
