About Radiosurgery
>What is Radiosurgery?
> Evaluation for Radiosurgery
> The Role of Radiosurgery
> Frequently Asked Questions
> Our Experts
What is Radiosurgery?
Stereotactic radiosurgery is the very precise delivery of radiation to
a brain tumor while sparing the surrounding normal brain tissue. Because
it is so precise, stereotactic radiosurgery allows a higher dose of radiation
to be given with more sparing of normal brain than can be achieved with
conventional radiotherapy techniques. To achieve this precision, we use
special procedures for identifying the position of the brain tumor. Information
from MRI and/or CT scans are directly transferred to the treatment planning
computer system to create a 3-D model of the tumor and surrounding normal
brain. The 3-D image allows us to precisely identify and target the position
of the abnormality to be treated. A complex radiation delivery planning
system is utilized to target a high dose of radiation at the tumor while
greatly limiting the dose to nearby normal brain. Special devices are
used to keep the head still so that the radiation will be aimed with great
accuracy at the targeted tumor. An experienced and specialized team of
neurosurgeons, radiation oncologists, and physicists work together to
plan and administer the radiation.
Evaluation for Radiosurgery
The first step in the radiosurgery process is the consultation. During
the consultation the Johns Hopkins physicians will determine whether radiosurgery
is the optimal treatment, discuss any alternative options, and describe
the procedure and side effects. In most situations, you will meet with
both a neurosurgeon and a radiation oncologist to discuss all the treatment
options available. For those occasions when radiosurgery is not the most
optimal treatment, Johns Hopkins offers the full array of alternative
treatment options including an experienced neurosurgery specialty service
and other advanced technologies for administering highly conformal radiotherapy.
The Role of Radiosurgery
Radiosurgery is a therapeutic option for many types of brain conditions.
The most common illnesses treated with radiosurgery include acoustic neuroma,
brain metastasis, meningioma, pituitary adenoma, craniopharyngioma, chordoma,
hemangioblastoma, anteriovenous malformation (AVM), and glioma/glioblastoma.
For more information about radiosurgery for these diagnoses please click
on the links located along the left hand side of this page.
Radiosurgery may not be useful in situations
where very large areas need to be treated or where the tumor extends into
surrounding normal brain. These are situations where areas of normal brain,
not just tumor, may need to be targeted because there may be extensions
of tumor within those normal appearing areas. In this circumstance, other
highly conformal radiation techniques, such as gamma knife, may be recommended
which can safely treat these larger areas while shielding as much normal
brain as possible.
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Frequently Asked
Questions
Q: What Should I Bring to the Consultation?
A:
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The most recent MRI, and the prior MRI studies for comparisons.
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The records of prior tests, medical treatments, surgical treatments or prior radiation treatments (if applicable)
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Audiograms (acoustic neuromas)
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Vision tests (pituitary tumors)
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Endocrine studies by endocrinologist (pituitary tumors and meningioma)
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Chemotherapy flow chart
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If the "simulation" (see below) has already been scheduled, please bring the recent blood test
results including the "BUN" and "creatinine" (indices of kidney function).
Q: What Questions Will I Be Asked?
A: Patient History
The patient history is the summary of the events leading up to the diagnosis.
The history includes the time of the first symptoms, the progression of
symptoms and the emergence of new symptoms over time. The history of the
presenting illness or chief complaint should include the following:
Symptom onset (short time ago vs. long-standing)
Duration
Course of the condition (static, progressive, or worse then better)
Associated symptoms such as imbalance, ringing in ear(s), hearing loss,
seizures, headache, nausea, vomiting and pain
Pain should be further defined by:
Location Radiation Quality Severity or quantity
Precipitating factors
Relieving factors
The history includes the dates and descriptions of any medical procedures including surgery, radiation or chemotherapy.
Q: What is the Neurological Examination?
A: The neurological examination allows the evaluation of specific
function that is immediately relevant to the diagnosis. The neurologic
examination includes mental status, cranial nerve, motor (strength), sensory
(sensation), cerebellar (co-ordination), and gait examinations.
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