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Removal of brain tumors – surgery without a knife

Today, the treatment of brain tumors, both malignant and benign, is increasingly used direction of radiation therapy, which uses high-precision radiation, the so-called stereotactic.

What is stereotactic radiation?
Stereotactic radiation as a radiosurgery area involves the use of high doses of radiation that act directly on the tumor. At the same time, healthy tissues located near the tumor are almost not affected, and pathological cells are destroyed. That is why stereotactic irradiation is also called high-precision.

The medical procedure for stereotactic irradiation is performed on the “gamma-knife” unit, but, contrary to this name, it is not a surgical operation in the literal sense of the word, since the external tissues are not damaged, their integrity is not impaired.

What happens to a tumor when irradiated?
Tumor cells are distinguished by the fact that their division occurs at a high rate, which causes the growth of the neoplasm. For the process of cell division is their DNA. Irradiation with high doses damages the DNA of pathological cells, and they stop multiplying and die.

When exposed to radiation, about 200 radioactive beams focus directly on the tumor and act as a surgeon’s knife, destroying the DNA of abnormal cells.

How is the procedure?
Before irradiation, the patient is examined, and according to the results of the examination, the dose and direction of irradiation are calculated.

The patient lies on a special table. During irradiation, the head must be strictly immobile. After all, any, even subtle movements, for example, when breathing, can shift the path of the beam of rays. To eliminate this, the patient’s head is fixed with a helmet – a stereotactic frame, which is placed under local anesthesia. The frame is made with special openings in which there are radiation sources – radioactive cobalt.

The procedure is performed without anesthesia, the radiation itself is completely painless. But the patient may feel the squeeze that the frame creates. Minor pain may occur after the procedure at the site of installation of the helmet retainers.

The procedure lasts from 10 minutes to several hours – it all depends on how deep the tumor is and how much it should be irradiated. After the procedure, the patient can go home.

Pros and cons of the procedure
Advantages of the procedure:

she is bloodless;
performed without anesthesia;
gives you some complications;
affects healthy tissue a little;
usually one procedure is enough to get the result;
after it, rehabilitation is not required.
Disadvantages of the procedure:

when the head is fixed in the stereotaxic frame after the termination of the local anesthesia, pain may occur, lasting for 1–2 days;
there is a possibility of recurrence due to irregularity of radiation in the center of the tumor and in the periphery;
high cost, and in case of treatment by quotas of the HMW (high-tech medical care) – a long wait for the operation.
Who shows the procedure?
It is used for various benign and malignant brain tumors:

meningiomas – if the degree of relapse is high in case of surgery; the procedure allows to work on hard-to-reach and multiple tumors;
pituitary adenomas – in case of impossibility of surgical removal of the tumor, with relapses, including hormone-active, with the impossibility or ineffectiveness of conservative treatment;
craniopharyngioma – with small relapses in adults and children; these tumors are radiosensitive and do not require the use of high doses of radiation;
paraganglioma – due to the reduction of surgical activity in relation to the jugular and tympanic paragangliomas, the area of ​​radiosurgery occupies a leading position in the removal of these tumors;
hemangioblastomas – the procedure reduces the tumor in most cases;
glial tumors – the procedure is used for small tumors with a clear contour, to remove residues of benign tumors of the first degree and for their recurrences, etc.
brain metastases;
vascular malformations, angiomas and aneurysms;
lesions of the cranial nerves (trigeminal neuralgia, acoustic neuroma). In the absence of pronounced neurological symptoms, the procedure is highly effective, nerve dysfunction after it is quite rare.
But we must understand that the use of “gamma-knife” is not a panacea. There are certain indications for this procedure. Detailed information on indications and contraindications in each case can only be reported by a doctor.

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