Gamma Knife® radiosurgery: its use and indications in neuro-ophthalmology

Abstract

Introduction: Gamma Knife ® radiosurgery combines the technologies of converging gamma ray radiation with modern imaging techniques to create sharply localized, controllable tissue destruction within the cranium without craniotomy. This technique allows for treatment of small intracranial lesions that may be inaccessable to conventional neurosurgery, either because of patient health or because of lesion proximity to sensitive structures. Materials and methods: All patients had ophthalmological examination by neurosurgery, extensive neuroimaging, and careful dosimetry planning prior to treatment. Delivery of the radiosurgery with the Gamma Knife ® then involves positioning the patient in a special dome-shaped structure, which allows the precise delivery of Cobalt-6O generated gamma rays in a focused beam to the lesion. Results: We illustrate how seven patients with vision-threatening lesions were successfully treated with the Gamma Knife ® with preservation of visual function. Conclusions: Gamma Knife ® can be successfully used to treat vision-threatening lesions that are not accessible to conventional surgery or where conventional surgery carries a large risk of damage to the visual apparatus.