An excellent presentation by Dr Stephen Tatter (Neurosurgeon) and Dr Michael Chan(Radiation Oncologist) from the Wake Forest Baptist Comprehensive Cancer Medical Centre on the Leksell Perfexion Gamma Knife unit operation. This is a form of radiation therapy for specific brain and skull base abnormalities requiring the placement of the Leksell 4 point fixation skull frame then MR (some centre also use CT) imaging and preparation of a treatment plan using the Gamma Knife.This is a radiation delivery system with no actual 'incision' ,using 192 beams of gamma radiation through arrays of collimators.with Cobalt 60 'live' source.All the beams merge onto the prescribed number of 'targets' or 'shots'.Using Leksell software the entire lesion can be delivered an ablative dose of radiation.The accuracy is 0.1 to 0.3 mm.The conforming line is the point of dramatic drop off of radiation and adjacent normal tissue is not damaged.The gamma radiation works by causing covalent bonds between the two DNA strands in the tissue irradiated and cell division cannot occur. The half life of the covalent bonds is over 50 years.

Not all brain lesions can be gamma knifed. Ideal cases are: selected acoustic neuromas <3 cm, certain cases of brain metastatic disease, pituitary tumours, chondrosarcomas/chordomas, AVMs, trigeminal neuralgia and functional movement disorders.

Please consult with your Neurosurgeon or Neurologist whether you are a candidate and referral to a gamma knife facility may be organised for evaluation.

Michael Coroneos : Senior Neurosurgeon

CIME MASE FRACS FRCS(EDIN)SN FRCS(IRE) FRCS(ENG) FACS(USA) FAIM MB BS(1st Class Honours) MNSA MNSQ MAPS

Item added 26 January 2016

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