61798 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion

Name of the Procedure:

Stereotactic Radiosurgery (Particle Beam, Gamma Ray, or Linear Accelerator); 1 Complex Cranial Lesion

Summary

Stereotactic radiosurgery (SRS) is a non-invasive medical procedure that uses precise, high-dose radiation to treat complex cranial lesions, such as tumors or other abnormalities in the brain. Despite the name, it is not a traditional surgery, as it involves no incisions.

Purpose

The purpose of SRS is to target and treat complex cranial lesions with high precision to minimize damage to surrounding healthy brain tissue. This method is often used for conditions that are hard to reach or treat with conventional surgery.

Indications

SRS is indicated for:

• Brain tumors (benign or malignant)
• Arteriovenous malformations (AVMs)
• Trigeminal neuralgia
• Metastatic brain lesions
• Other complex cranial lesions

Patient criteria generally include having a well-defined lesion and the need for a minimally invasive treatment option.

Preparation

• Patients may be required to fast for a few hours before the procedure.
• Medications may need to be adjusted; specific instructions will be provided by the healthcare team.
• Pre-procedure diagnostic tests, such as MRI or CT scans, are necessary to map the exact location of the lesion.

Procedure Description

1. The patient is fitted with a head frame or a mask to keep the head still.
2. Detailed imaging scans (MRI or CT) are taken to pinpoint the location of the lesion.
3. The radiation team uses these images to plan the precise delivery of radiation.
4. The patient is positioned on a treatment table, and the radiosurgery device (particle beam, gamma ray, or linear accelerator) is used to deliver focused radiation to the cranial lesion.
5. The entire process is monitored by the medical team to ensure accuracy.

Anesthesia or sedation may be used to ensure the patient remains still and comfortable during the procedure.

Duration

The procedure typically takes between 30 minutes to several hours, depending on the complexity and size of the lesion.

Setting

SRS is performed in a specialized facility, often within a hospital or an outpatient clinic equipped with advanced imaging and radiation technology.

Personnel

• Radiation oncologists
• Neurosurgeons
• Medical physicists
• Radiologists
• Nurses
• Anesthesiologists (if sedation is used)

Risks and Complications

• Fatigue
• Headache
• Nausea
• Swelling in the treated area
• Rare, but possible, complications include radiation necrosis or damage to surrounding brain tissue.

Benefits

• Non-invasive with no surgical incisions
• High precision with minimal damage to healthy tissue
• Short recovery time
• Effective for treating inoperable or hard-to-reach lesions

Recovery

• Patients can usually go home the same day.
• Follow-up imaging and appointments are required to monitor the lesion's response.
• Some patients may experience mild side effects, such as fatigue or headaches, which typically resolve in a few days.

Alternatives

• Conventional surgery
• Whole-brain radiation therapy
• Chemotherapy
• Observation and regular monitoring

Each option has its pros and cons, such as varying invasiveness, recovery times, and side effects, which should be discussed with a healthcare provider.

Patient Experience

During the procedure, the patient should not feel pain, but may experience pressure from the head frame or mask. After the procedure, mild fatigue or headaches are common. Pain management and comfort measures will be provided as needed.