Patient Guide

The Gamma Radiosurgery actually is an extremely effective, precise, and safe radiation instrument used to perform brain radiation treatment. Because the Gamma Radiosurgery uses radiation, this treatment is often referred to as Radiosurgery. No incision or cut is made, which means there is a very low risk of treatment complications. Your head will not be shaved.

With the Gamma Radiosurgery, doctors are able to direct radiation to a focal point to treat a brain tumor, Trigeminal Neuralgia and/or to correct abnormal formations in the brain's artery and vein systems. The Gamma Radiosurgery aims radiation precisely on the abnormal brain tissue (often referred to as a lesion) and alters it without affecting surrounding healthy tissue. You will go home the same day. You may resume your normal activities the next day. You will not be able to drive for 24 hours.

Our Radiosurgical Center is a dedicated facility, which means it is used for brain radiosurgery only. Each of us at the Center wants you to feel comfortable and informed about Gamma Radiosurgery surgery. If you have questions or need more information, please talk with your doctors and nurses about anything you do not understand.

The evening before your treatment, you must not eat or drink anything after midnight. This will lessen the chance that you will have an upset stomach during your procedure. We would also like you to wash your hair thoroughly the night before surgery or the morning of. If you take regular medications, be sure to talk with your surgeon about how to do this on the day of your surgery, and be sure to bring your medications with you to the Gamma Radiosurgery Center. If you are a Diabetic, bring all of your medicines with you. Do not take your Diabetic medicine.

On the morning of your treatment, you will come to the Methodist University Hospital, located 1265 Union Avenue, Memphis, TN 38104. The parking garage is on the back side of the hospital on Eastmoreland. There is a walkway from the garage to the outpatient admissions area. You will check in at the outpatient admissions desk for your MRI or CT. They will then send you to the Radiosurgical Center to complete your paperwork. At that time, you will change into a gown and your IV will be started for your contrast. It is often very cold in the Center, so wear warm pants and socks (these may be kept on, unless you are having an angiogram). At the Center, you will meet your nurse, neurosurgeon, radiation oncologist, and other members of the Gamma Radiosurgery team. Please feel free to ask them questions about your surgery.

After you are comfortably settled in the pre-procedural room at the Radiosurgery Center, a history will be obtained and you will talk with your physician prior to any sedation. Please inform us of any local anesthesia allergy.  Please leave all valuables at home.

Due to limited space, please have no more than two people accompany you.

Before preparation for your treatment actually begins, you will be given a mild sedative through your IV.

When you are ready, some small areas of your head will be cleaned with alcohol. No hair will be shaved from your head. A special device called a stereotactic frame will be attached to the skull and held firmly in place by four pins: two in the forehead and two in the back of the head.  To make sure you are as comfortable as possible during the attachment, a small amount of local anesthetic will be injected to numb the skin where each of the pins will be fixed. This frame will remain on your head until your treatment is completed. Please inform us of any local anesthetic allergy.

You will then be taken to the imaging area. Imaging studies help the Gamma Radiosurgery team pinpoint exactly where to target the radiation. The nurse, doctor and/or Patient Care Tech from the Radiosurgery Center will go with you to the imaging area. They will stay with you during your imaging procedures and then will bring you back to the Radiosurgery Center.

You will have either computed tomography (CT) scanning, magnetic resonance imaging (MRI), or both.

If you have an AVM, or arteriovenous malformation, it is possible you may also have an angiogram to provide your surgeon with a picture of the blood vessels in your brain. A small area on your groin or thigh will be shaved so a catheter (a tube) can be inserted into an artery. The catheter will be directed to your brain and dye will be sent through it to your brain's blood vessels. After the angiogram is completed, it will be necessary for you to lie flat on your back for several hours.

Your stereotactic frame will stay in place throughout all your imaging studies, and it will appear on your x-rays. The frame has special "markers" on its surface. These markers will be used to map the exact measurements necessary for your Gamma Radiosurgery surgery.

Your Neurosurgeon, Radiation Oncologist, and others will then need some time to plan your specific radiation dose. During this period you will rest on your bed in the Radiosurgery Center. Your nurses will be with you to monitor your heart rate and blood pressure and make sure you are as comfortable as possible.

When the measurements and plans for your specific treatment are complete, you will be placed on the Gamma Radiosurgery bed such that the frame holds your head securely in place.

Throughout your treatment your doctors and nurses can see you, talk with you, and monitor your condition. The Radiosurgery Suite is equipped with a video camera and intercom system, in addition to a complete system of physiological monitoring equipment.

The Gamma Radiosurgery's computerized program will begin your treatment by automatically moving your bed backward into the shielded sphere where the source of radiation is housed. The entrance door will open automatically to admit your head {with frame). The bed may move in and out several times to get the tumor treated.

When your radiosurgery is finished, the stereotactic frame will be removed. Band-aids and Neosporin ointment will be applied to each pin site. Some patients may have slight bleeding at the pin site. Applying pressure almost always stops the bleeding; if not, your surgeon will use a small stitch to close the pin site.

You will be allowed to rest for a short period during which you will be monitored. After this period of time, your doctor will decide when to discharge you home.

A very small number of patients have had a headache after removal of the frame, if you experience this, please tell your nurse. Your IV line will probably still be in place, but it will be removed as soon as you are able to drink fluids.

All patients are able to leave the Center the day of their Gamma Radiosurgery treatment. If a stitch was used to close a pin site, please remember that the stitch will be absorbed in five to ten days after treatment.

Before you leave The Center, your follow-up care will be discussed with you. Your follow-up care is very important. You will receive a form telling you when your physician wants to see you for follow-up, with a phone number to schedule your appointment and emergency contact information..

Keep in mind that Gamma Radiosurgery does not immediately alter a brain lesion. Total inactivation of the lesion may require varying periods of time. For this reason, it is important that you have regular evaluations and MRI or CT imaging studies to make sure you are responding to the treatment as planned.

For your follow-up care through your Gamma Radiosurgery neurosurgeon, you will be asked to contact his/her office to schedule your appointment.

You must have someone to drive you home. Going home instructions, verbal and written, will be given to you and your caregiver prior to you leaving the Center.