What is gamma knife surgery?

Gamma Knife surgery, also known as Gamma Knife radiosurgery (GKRS), is a noninvasive and high precision radiation therapy technique used in the treatment of various brain disorders (Xu et al., 2017). It involves the use of multiple cobalt-60 sources to deliver focused radiation to intracranial lesions that are either inaccessible or unsuitable for traditional open surgery (Mahmoudi et al., 2018). GKRS has been established as a valuable therapeutic option for conditions such as glomus jugulare tumors (Ibrahim et al., 2017), central neurocytomas (Dedeciusova et al., 2022), brain metastases (Ma et al., 2023), meningiomas (Hu et al., 2020), craniopharyngiomas (Tsugawa et al., 2020), and arteriovenous malformations (Tsuei et al., 2019). Compared to conventional cerebral surgery, Gamma Knife surgery is considered safer, causes less bleeding, and requires a shorter recovery time (Ma et al., 2023).

The effectiveness of Gamma Knife surgery has been demonstrated in various studies, showing positive outcomes in terms of tumor control and patient safety (Vymazal & Chytka, 2021; Thapa et al., 2021). It has been used successfully in the treatment of conditions like trigeminal neuralgia (Sumayli et al., 2017), refractory epilepsy (Kumar et al., 2019), and even obsessive-compulsive disorder in cases where pharmacological therapy has failed (Zaed et al., 2019). Additionally, Gamma Knife surgery has been employed in the management of brain tumors, achieving obliteration of aneurysms and feeding arteries without neurological deterioration (Vymazal & Chytka, 2021).

In conclusion, Gamma Knife surgery stands out as a valuable and effective treatment modality for a wide range of intracranial conditions, offering a noninvasive and precise alternative to traditional open surgery with favorable outcomes in terms of tumor control and patient safety.

References #

1. Dedeciusova, M., Prior, J., Schiappacasse, L., Patin, D., Levivier, M., & Tuleasca, C. (2022). The role of single fraction gamma knife radiosurgery for intraventricular central neurocytomas and the utility of f-18 fluroethyltyrosine: two case reports. Journal of Medical Case Reports, 16(1). https://doi.org/10.1186/s13256-022-03665-4
2. Hu, Y., Yuebing, X., Zhang, L., Ding, C., & Chen, J. (2020). Comparison of clinical outcomes in patients who underwent gamma knife radiosurgery for parasellar meningiomas with or without prior surgery. BMC Neurology, 20(1). https://doi.org/10.1186/s12883-020-01731-2
3. Ibrahim, R., Ammori, M., Yianni, J., Grainger, A., Rowe, J., & Radatz, M. (2017). Gamma knife radiosurgery for glomus jugulare tumors: a single-center series of 75 cases. Journal of Neurosurgery, 126(5), 1488-1497. https://doi.org/10.3171/2016.4.jns152667
4. Kumar, R., Yadav, J., Sahu, J., Tripathi, M., Ahuja, C., & Dayal, D. (2019). Episodes of prolonged “trance-like state” in an infant with hypothalamic hamartoma. Annals of Pediatric Endocrinology & Metabolism, 24(1), 55-59. https://doi.org/10.6065/apem.2019.24.1.55
5. Ma, K., Zhao, D., Li, X., Duan, H., Chen, Y., Wang, S., … & Li, F. (2023). Case report: multiple brain metastases of atrial myxoma: clinical experience and literature review. Frontiers in Neurology, 13. https://doi.org/10.3389/fneur.2022.1046441
6. Mahmoudi, A., Shirazi, A., Geraily, G., nia, T., Bakhshi, M., & Maleki, M. (2018). Penumbra width determination of single beam and 201 beams of gamma knife machine model 4c using monte carlo simulation. Journal of Radiotherapy in Practice, 18(1), 82-87. https://doi.org/10.1017/s1460396918000407
7. Sumayli, A., Boqursain, S., Alnuwaiser, A., Sari, A., Albaqawi, R., Mania, K., … & Daghriri, M. (2017). The effectiveness of gamma knife surgery in the treatment of trigeminal neuralgia : a systematic review. The Egyptian Journal of Hospital Medicine, 69(6), 2647-2651. https://doi.org/10.12816/0042242
8. Thapa, S., Shimizu, F., Kitazono, I., Yonenaga, M., Masuda, K., Kuroki, S., … & Yoshimoto, K. (2021). Solitary fibrous tumor or hemangiopericytoma of the sella in an older patient treated with partial removal followed by fractionated gamma knife radiosurgery. NMC Case Report Journal, 8(1), 697-703. https://doi.org/10.2176/nmccrj.cr.2021-0103
9. Tsuei, Y., Luo, C., Fay, L., Yang, H., Guo, W., Wu, H., … & Teng, M. (2019). Morphologic change of flow-related aneurysms in brain arteriovenous malformations after stereotactic radiosurgery. American Journal of Neuroradiology. https://doi.org/10.3174/ajnr.a6018
10. Tsugawa, T., Kobayashi, T., Hasegawa, T., Iwai, Y., Matsunaga, S., Yamamoto, M., … & Yasuda, S. (2020). Gamma knife surgery for residual or recurrent craniopharyngioma after surgical resection: a multi-institutional retrospective study in japan. Cureus. https://doi.org/10.7759/cureus.6973
11. Vymazal, J. and Chytka, T. (2021). Gamma knife radiosurgery of distal aneurysm: a case series. Stereotactic and Functional Neurosurgery, 99(5), 381-386. https://doi.org/10.1159/000513956
12. Xu, Y., Bhatnagar, J., Bednarz, G., Flíckinger, J., Arai, Y., Vacsulka, J., … & Huq, M. (2017). Failure modes and effects analysis (fmea) for gamma knife radiosurgery. Journal of Applied Clinical Medical Physics, 18(6), 152-168. https://doi.org/10.1002/acm2.12205
13. Zaed, I., Roumy, L., Lozito, A., & Ureiche, V. (2019). Gamma knife surgery (gks) for the treatment of obsessive-compulsive disorder (ocd) refractory to pharmacological therapy: state of the art and review of the literature. Sn Comprehensive Clinical Medicine, 1(11), 944-951. https://doi.org/10.1007/s42399-019-00141-x