Name of the Procedure:

Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based.

Summary

In stereotactic radiosurgery (SRS) using a linear accelerator, high-dose radiation beams are precisely targeted to destroy cranial lesions in a single session. This non-invasive procedure uses advanced imaging to treat affected areas without harming surrounding healthy tissue.

Purpose

Medical condition: This procedure addresses cranial lesions, including benign and malignant tumors, arteriovenous malformations (AVMs), and other abnormalities. Goals and Outcomes: The primary goal is to eliminate or reduce the size of the lesion with minimal impact on healthy tissue, potentially improving neurological function and alleviating symptoms.

Indications

Symptoms/Conditions: SRS is indicated for patients with intracranial tumors (both primary and metastatic), AVMs, trigeminal neuralgia, and certain pituitary gland disorders. Criteria: Suitable for patients with identifiable, well-defined lesions that can be precisely targeted using imaging technologies. Usually recommended when traditional surgery is high-risk or not feasible.

Preparation

Instructions: Patients may need to undergo fasting for a specified period before the procedure. Medications might need to be adjusted or withheld as advised by the doctor. Assessments: Pre-procedure imaging (e.g., MRI, CT scans) is required to map the exact location and size of the lesion. Baseline neurological exams and blood tests may also be conducted.

Procedure Description

Steps:

1. Immobilization: The patient’s head is secured in a custom-fitted mask or frame to prevent movement.
2. Imaging: Advanced imaging techniques (MRI, CT) are used to identify the precise location of the lesion.
3. Planning: A treatment plan is developed using specialized software to direct the radiation beams accurately.
4. Delivery: High-dose radiation beams are delivered from multiple angles using a linear accelerator, converging on the lesion while sparing surrounding tissues. Tools: Linear accelerator, immobilization devices, imaging equipment. Anesthesia: Local anesthesia may be applied to enhance comfort; sedation is usually not necessary.

Duration

The procedure typically takes between 30 minutes to 2 hours, depending on the complexity and size of the lesion.

Setting

Performed in a specialized radiation therapy unit within a hospital or outpatient clinic equipped with advanced imaging and radiation delivery systems.

Personnel

Healthcare Professionals: Radiation oncologist, medical physicist, radiation therapist, and radiology technician may be involved in the procedure.

Risks and Complications

Common risks include fatigue, mild skin reactions, and temporary swelling of the brain leading to headaches or nausea. Rare but serious complications might involve radiation necrosis, neurological deficits, or secondary malignancies.

Benefits

Expected Benefits: Effective in reducing or eliminating targeted lesions with minimal damage to healthy tissue. Symptom relief might be observed within weeks to months. Realization Time: Benefits can be experienced shortly after the procedure, with maximum effects observed several weeks to months later.

Recovery

Post-procedure Care: Patients can usually go home the same day. Follow-up imaging may be scheduled to monitor the lesion’s response. Recovery Time: Patients can resume normal activities within a day or so, with minimal restrictions. Follow-up appointments ensure proper healing and assessment of treatment efficacy.

Alternatives

Treatment Options: Alternatives include traditional neurosurgery, fractionated stereotactic radiotherapy (multiple sessions), chemotherapy (for malignancies), and observation. Pros and Cons: SRS offers a non-invasive option with a shorter recovery time compared to traditional surgery but might not be suitable for large or irregularly shaped lesions.

Patient Experience

During: Patients typically remain awake and comfortable, with a sensation of pressure from the immobilization device but no pain. After: Mild fatigue and headaches are common but manageable with over-the-counter pain relief. Most patients return to daily activities quickly. Regular follow-up appointments are necessary to monitor progress.

Pain management and comfort measures are tailored to individual needs to ensure a positive experience during and after the procedure.