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Conditions Treated with Gamma Knife® Surgery
The Gamma Knife treats a number of neurological brain diseases including vascular disorders, benign and malignant tumors, functional disorders and ocular disorders. The volume of each disease type as a percentage of overall Gamma Knife cases is indicated by the pie chart below.
In addition, the Gamma Knife® is used as an investigational tool for certain forms of epilepsy and psychiatric disease.
Source: Leksell Gamma Knife Society, December 2005; North and South America, 89 of 112 units reporting; 100,417 patients, Dec. 1991 – December 2005
Malignant Tumors
Metastatic Tumor
Brain tumors are abnormal growths of tissue found inside the skull, which is a primary component of the central nervous system (CNS). Malignant tumors are cancerous. The CNS is housed within rigid, bony quarters (i.e., the skull and spinal column), so any abnormal growth, whether benign or malignant, can place pressure on sensitive tissues and impair function. Tumors that originate in the brain or spinal cord are called primary tumors. Most primary tumors are caused by out-of-control growth among cells that surround and support neurons. In a small number of individuals, primary tumors may result from specific genetic disease (e.g., neurofibromatosis, tuberous sclerosis) or from exposure to radiation or cancer-causing chemicals. The cause of most primary tumors remains a mystery. They are not contagious and, at this time, not preventable. Symptoms of brain tumors include headaches, seizures, nausea and vomiting, vision or hearing problems, behavioral and cognitive problems, motor problems, and balance problems. The first test to diagnose brain tumors is a neurological examination. Special imaging techniques (computed tomography, and magnetic resonance imaging, positron emission tomography) are also employed. Laboratory tests include the EEG and the spinal tap. A biopsy, a surgical procedure in which a sample of tissue is taken from a suspected tumor, helps doctors diagnose the type of tumor.
Malignant Glial Tumor (Grade III+IV)
A cancerous tumor of the central nervous system that includes astrocytomas, ependymal tumors, glioblastoma multiforme, and primitive neuroectodermal tumors.
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Benign Tumors
Acoustic Neuroma (Vestibular Schwannoma)
Acoustic Neuroma is a benign (non-cancerous) growth that begins at the 8th cranial nerve, which runs from the brain to the inner ear. Any disruption of the signals sent along the 8th cranial nerve will interfere with hearing and with the patient’s balance.
Meningioma
Meningiomas are benign, slow-growing tumors, classified as brain tumors, but actually growing in the three protective membranes that surround the brain (meninges). Sometimes they cause thickening or thinning of adjoining skull bones. Meningiomas do not spread to other areas of the body.
Pituitary Adenoma
Pituitary tumors are abnormal growths found in the pituitary gland, a small organ--about the size of a dime and located in the center of the brain--which makes hormones that affect growth and the functions of other glands in the body. Most pituitary tumors are benign, which means they are non-cancerous, grow slowly and do not spread to other parts of the body. A pituitary tumor may make the pituitary gland produce too many hormones, which can cause other problems in the body. Tumors that make hormones are called functioning tumors, while those that do not make hormones are called non-functioning tumors. Certain pituitary tumors cause Cushing's disease in which fat builds up in the face, back and chest, and the arms and legs to become very thin. Other pituitary tumors can cause acromegaly, a condition in which the hands, feet and face are larger than normal. Another type of tumor can cause breasts to make milk even though there is no pregnancy. Symptoms of pituitary tumors may include headaches, vision problems, nausea and vomiting, or any of the problems caused by the production of too many hormones such as infertility or loss of menstrual periods in women, abnormal growth, high blood pressure, heat or cold intolerance, and other skin and body changes.
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Functional Disorders
Trigeminal Neuralgia
Trigeminal neuralgia (TN) is a chronic pain condition that causes extreme, sporadic, sudden burning or shock-like face pain that lasts anywhere from a few seconds to as long as 2 minutes per episode. The intensity of pain can be physically and mentally incapacitating. TN pain is typically felt on one side of the jaw or cheek. Episodes can last for days, weeks, or months at a time and then disappear for months or years. In the days before an episode begins, some patients may experience a tingling or numbing sensation or a somewhat constant and aching pain. The attacks often worsen over time, with fewer and shorter pain-free periods before they recur. The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind. TN occurs most often in people over age 50, but it can occur at any age, and is more common in women than in men. There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation. Although sometimes debilitating, the disorder is not life-threatening.
The presumed cause of TN is a blood vessel pressing on the trigeminal nerve in the head as it exits the brainstem. TN may be part of the normal aging process but in some cases it is the associated with another disorder, such as multiple sclerosis or other disorders characterized by damage to the myelin sheath that covers certain nerves.
All descriptions are provided by the National Institute of Neurological Disorders and Stroke;
www.ninds.nih.gov
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Vascular Disorders
Arteriovenous Malformations
Arteriovenous malformations (AVMs) are defects of the circulatory system that are generally believed to arise during embryonic or fetal development or soon after birth. Although AVMs can develop in many different sites, those located in the brain or spinal cord can have especially widespread effects on the body. Most people with neurological AVMs experience few, if any, significant symptoms. The malformations tend to be discovered only incidentally, usually either at autopsy or during treatment for an unrelated disorder. But for about 12 percent of the affected population (about 36,000 of the estimated 300,000 Americans with AVMs), these abnormalities cause symptoms that vary greatly in severity. Seizures and headaches are the most generalized symptoms. AVMs also can cause a wide range of more specific neurological symptoms that vary from person to person, depending primarily upon the location of the AVM. Such symptoms may include muscle weakness or paralysis, loss of coordination, difficulties carrying out tasks that require planning, dizziness, visual disturbances, problems using or understanding language, abnormal sensations (such as numbness, tingling, or spontaneous pain), memory deficits, mental confusion, hallucinations, or dementia.
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