Sacred Heart Medical Center: Oregon Neurosciences Institute: Gamma Knife Center

How Gamma Knife Surgery Works
Referrals for Gamma Knife Surgery
The Procedural Process

Gamma Knife Surgery
Gamma Knife surgery is a well-established procedure used to treat certain brain disorders. The Gamma Knife is not a knife in the normal sense of the word. The doctor makes no incisions in your head. Instead, the Gamma Knife surgeon directs very precisely focused beams of radiation to the treatment area in the brain. Gamma Knife surgery offers a safe and effective treatment for more than 30,000 patients every year. The treatment procedure is simple, bloodless, and painless.

How Gamma Knife Surgery Works
Gamma Knife surgery delivers extremely focused radiation beams to targets in the brain. A total of 201 individual beams converge on one spot. The radiation source used is called cobalt. The shape and dose of the radiation is set up to hit only the target, without damaging surrounding healthy brain tissue.

Treatment
The treatment consists of four steps:
1. The head frame
3. Imaging
3. Treatment planning
4. Treatment

Before the Treatment
Before the treatment, your doctor will inform you about the entire procedure. With Gamma Knife surgery, you will not have to have your head shaved. The next step is the application of the head frame.

The Head Frame
The doctor will place your head in a frame. The frame allows the doctor to accurately pinpoint the target to be treated in your brain. This lightweight frame, which is attached to your head with four screws, ensures that the radiation beams are directed with precision to the target. The frame also prevents your head from moving during imaging and treatment procedures. A local anesthetic is applied where the screws are attached.

Imaging
After the head frame is in place, technologists take images of your brain. You may have magnetic resonance imaging (MRI), computed tomography (CT), or angiography imagining (AI). Imaging is required to determine the exact size, shape, and position of the target in the brain.

During imaging, a box is placed on the head frame to provide reference points on the images for the treatment plan. After imaging, the box is removed.

Treatment Planning
Once your images have been taken, you can rest while your physician develops a very precise and accurate treatment plan. No two treatment plans are alike. Your plan is designed to address your specific medical condition. The doctor, along with other specialists in the team, makes the plan in a specially designed computer and calculates how the treatment should be performed. This usually takes a couple of hours.

The Treatment
Once your treatment plan is completed, the actual treatment starts. You lie on the treatment couch, and the head frame is attached to a helmet that goes over your head. You are awake during the procedure and will be able to communicate with your doctor or nurse through an audio and video connection. When the treatment begins, the couch moves into the dome section of the unit. The treatment is silent and totally painless. If your doctor allows, you may be able listen to music during the treatment.

The team monitors the procedure at all times. The treatment lasts a few minutes to more than an hour, depending on the size and shape of the target.

In most cases following Gamma Knife surgery, the patient leaves the hospital the same day and returns to daily life. Some patients experience side effects immediately after the treatment, but they are usually mild. The most common are headache, dizziness, nausea, and seizures. The side effects disappear soon after the procedure.

Your doctor will tell you whether he or she wants you to stay overnight for observation or if you can go home immediately. Either way, you should be able to return to your normal routine in another day or so.

After the Treatment
When your treatment is complete, the head frame is removed. If you had an angiogram, you might have to lie quietly for several more hours.

In most cases following Gamma Knife surgery, the patient leaves the hospital the same day and returns to daily life. Some patients experience side effects immediately after the treatment, but they are usually mild. The most common are headache, dizziness, nausea, and seizures. The side effects disappear soon after the procedure.

Your doctor will tell you whether he or she wants you to stay overnight for observation or if you can go home immediately. Either way, you should be able to return to your normal routine in another day or so.

Follow-Up
The effects of your treatment will occur over time. Radiation treatments are designed to stop the growth of tumors or lesions, which means that the effect will be seen over a period of weeks or months. Your doctor will stay in contact with you to assess your progress, which may include follow-up MRI, CT or AI.

Care for Our Patients
Referrals for Gamma Knife Surgery
If your doctor has determined that you are a potential candidate for Gamma Knife surgery, he or she may refer you to one of our Gamma Knife specialists by calling (541) 984-4266 or (866) 914-2662. Our team of neurosurgeons, radiation oncologists, medical physicists, nurses, and technicians unite to provide you with the best possible physical, clinical and emotional experience.

The Procedural Process
During your initial consultation, the radiation oncologist and/or neurosurgeon will conduct an evaluation, review your films, and discuss your procedure. This is typically done the day before the Gamma Knife surgery. However, in certain cases, the consultation could occur earlier or on the same day of surgery, depending on your needs.

You can expect a half-day stay at Sacred Heart Medical Center, even though your actual procedure may be much shorter. Because the surgical procedure requires an early morning start, our guest services staff will be happy to help arrange overnight accommodations for out-of-town patients and accompanying family members.