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TREATMENT AND PROCEDURE-
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 compute rised
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.
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