61799 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure)

Name of the Procedure:

Stereotactic Radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex

Summary

Stereotactic radiosurgery is a non-invasive procedure that uses highly targeted radiation to treat additional complex cranial lesions (such as tumors) following an initial treatment. This method ensures that high doses of radiation are delivered accurately to specific areas in the brain without harming surrounding healthy tissue.

Purpose

Stereotactic radiosurgery addresses:

• Secondary or recurrent cranial lesions that need precise treatment.
• The goal is to control or eliminate the growth of these additional lesions while minimizing damage to nearby brain structures.

Indications

• Patients with multiple cranial tumors (e.g., metastases, benign brain tumors).
• Lesions not amenable to traditional surgery due to their size or location.
• Individuals whose primary lesions have already been treated.

Preparation

• Patients may be instructed to fast for a few hours before the procedure.
• Medications might need adjustment, particularly blood thinners.
• Pre-procedure imaging studies (CT or MRI) to map the exact location of the lesions.

Procedure Description

1. Patient is immobilized using a head frame or mask to ensure precision.
2. Detailed imaging (CT/MRI) is performed to pinpoint the lesions.
3. Treatment planning software calculates the optimal radiation dose.
4. The linear accelerator, gamma ray, or particle beam device delivers targeted radiation.
5. Each additional cranial lesion is addressed separately following the primary lesion's treatment.

Duration

The procedure typically takes several hours, depending on the number and complexity of the lesions.

Setting

Performed in a hospital or specialized outpatient clinic equipped with stereotactic radiosurgery technology.

Personnel

• Neurosurgeon or radiation oncologist
• Medical physicist
• Radiology technician
• Registered nurse
• Anesthesiologist, if sedation is used

Risks and Complications

• Common: Fatigue, headaches, temporary scalp irritation.
• Rare: Radiation necrosis, swelling due to radiation, neurological deficits.

Benefits

• Non-invasive, reducing recovery time compared to open surgery.
• Precise targeting minimizes damage to healthy tissue.
• Effective in controlling or eliminating additional complex cranial lesions.

Recovery

• Mild discomfort and fatigue are common, managed with over-the-counter pain relievers.
• Most patients can resume normal activities within a few days.
• Follow-up imaging and consultations to monitor lesion response and detect potential complications.

Alternatives

• Open surgery: More invasive and with a longer recovery period.
• Conventional radiotherapy: Less targeted and may affect surrounding healthy tissue.
• Chemotherapy: Systemic treatment with broader effects and potential side effects.

Patient Experience

• During the procedure, patients may feel slight discomfort from immobilization but do not feel the radiation itself.
• Post-procedure, mild fatigue and headaches are common, but generally, the recovery is swift with minimal restrictions. Pain management includes prescribed analgesics if needed.