GAMMA KNIFE CENTER -

• The radiosurgery technique has existed for many years.  Treatment by Gamma Knife started in 1968, but it really took of at the end of the 1980s, thanks to the appearance of new imaging techniques (scanner – magnetic resonance) and information technology.

• So you are not a “guinea pig” as hundreds of thousands of people have already been treated by Gamma Knife throughout the world.

The Gamma Knife is composed essentially of 2 parts:

• 192 sources of radioactive Cobalt that are placed in a “metal ball” that serves for armouring.

• 1 bed on which the patient lies during the treatment: the bed is moved to the irradiation sources.  At the front of the bed is the secondary collimator and the system for fixing the stereotaxic frame.  The head is fixed so as to obtain the highest precision possible during the treatment.  The secondary collimator is used to direct the gamma rays to the irradiation target.

• There is not much of a feeling of being closed in during the treatment:  the patient does not really go into the machine.  Patients who can stand magnetic resonance will have no problem during treatment with Gamma Knife.

• We have never had to interrupt a Gamma Knife intervention because of a problem with claustrophobia.  We can give you a mild tranquilliser if you are too nervous.  Finally, for people who cannot stand magnetic resonance because of a problem with claustrophobia, a radiosurgical intervention by Gamma Knife can be carried out under anaesthesia.

• The treatment in itself does not hurt.  The local anaesthesia necessary at the 4 points where the stereotaxic frame is fixed is slightly painful; but it is always well supported by the patients.  You will be given a sedative and a pain-killer by an anaesthetist before this local anaesthesia is carried out.
  
  

• Because treatment by Gamma Knife does not require general anaesthesia.  You thus avoid a general anaesthesia of several hours, from which it is more difficult to recover.  General anaesthesia is however used for non-cooperative patients (small children, etc.)

• These tests are required after the stereotaxic frame is placed, not in order to discover a lesion but to locate it very precisely in relation to the frame. 

• These images are absolutely necessary for planning the treatment.

• The stereotaxic frame is fixed on the patient’s head by a system of pressure and counter-pressure on the surface of the cranium; the 4 fixing points of the frame are not screwed into the cranium.  No complication can result from the fixing of the frame on the patient’s head.

• Sources of radioactive Cobalt 60 are placed inside the armour plating of the machine.  These sources emit gamma rays continuously.  As soon as the doors of the Gamma Knife are opened, gamma radiation is disseminated in the room.  This “extra-cerebral” radiation is very low and cannot be dangerous for the patient.  However, for the attending personnel, which would be exposed thereto every day, cumulative irradiation doses could prove harmful in the long term (as is the case in radiology units, scanners, etc.)

• The patient must therefore stay alone in the room during the treatment, but is under surveillance by the attending personnel in the next room.  A camera and an interphone are used to communicate verbally and visually during the treatment.

• The treatment can be interrupted at all times.  We ask the patient to use the interphone for any and all requests or if any problem should occur during the treatment.

• If the patient so desires, the treatment can be interrupted to drink a glass of water, stretch one’s legs… and then be resumed.

• No local anaesthesia is needed to remove the 4 attachments of the stereotaxic frame. The removal of the frame itself (which takes only 1 minute or so) does not hurt, but the change of pressure on the cranium may cause a temporary headache, for which a pain-killer is given when necessary.

• The 4 fixing points of the frame make a small punctiform orifice on the skin that requires no sutures.  A simple dressing suffices.  Cicatrisation is very rapid

• The day after the treatment, the dressing is removed and the frame fixing points are disinfected by the nurse.  The patient can then leave the hospital.

• For the whole staff of our Center (physicians, nurses, secretary...) there is no problem to take you in charge in English. All the members of our Center could not speek fluently English, but we can always explain you the important informations in your own language.