Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Application of stereotactic headframe for stereotactic radiosurgery
Summary
In layman's terms, this procedure involves attaching a special headframe to a patient's skull to help guide high-precision radiation treatments aimed at tumors or other abnormalities in the brain.
Purpose
This procedure helps to treat brain tumors, arteriovenous malformations, and other brain abnormalities by precisely targeting them with radiation. The goal is to deliver radiation to the problem area while sparing healthy brain tissue.
Indications
- Patients with brain tumors (benign or malignant)
- Arteriovenous malformations (AVMs)
- Functional disorders (e.g., trigeminal neuralgia)
- Metastatic brain lesions
- Recurrent or residual tumors after surgery
Preparation
- The patient may need to fast for a few hours before the procedure.
- Adjustments to current medications may be necessary.
- A full neurological examination and imaging tests like MRI or CT scans are usually performed prior to the procedure.
Procedure Description
- The patient is positioned comfortably, often with local anesthesia applied to the scalp.
- A stereotactic headframe, which is a rigid device, is affixed to the skull using pins or screws.
- MRI or CT imaging is used to map the exact location of the abnormality.
- Data from the imaging is used to plan the precise delivery of radiation during radiosurgery.
- The headframe ensures the patient's head remains completely still, optimizing the accuracy of radiation targeting.
Duration
The application of the headframe typically takes about 30 minutes, but the entire radiosurgery process may take several hours.
Setting
The procedure is usually performed in a hospital or a specialized outpatient clinic equipped with radiosurgery technology.
Personnel
- Neurosurgeon or radiation oncologist
- Radiologist
- Specialized nurses
- Medical physicist
Risks and Complications
- Minor bleeding or bruising where the frame is attached
- Headache or discomfort at the pin sites
- Rare risk of infection
- Potential swelling or irritation
Benefits
Provides highly precise treatment to brain abnormalities, minimizing damage to healthy tissue. The patient can often return to normal activities relatively quickly.
Recovery
- Patients might experience some scalp tenderness or headache.
- Instructions on managing discomfort are provided.
- Most patients can resume normal activities within a day or two.
- Follow-up imaging is typically scheduled to monitor the effects of the treatment.
Alternatives
- Traditional surgery might be an option but comes with higher risks and longer recovery times.
- Radiation therapy without a frame, though less precise.
- Chemotherapy for certain types of brain tumors.
Patient Experience
- Patients may feel pressure or slight pain when the headframe is being applied.
- During radiation treatment, patients need to stay very still but won't feel the radiation itself.
- Post-procedure discomfort is usually mild and manageable with medications.