A benign tumor of the eighth cranial nerve. It is sometimes called a vestibular schwannoma or neurinoma. This tumor grows slowly, and causes damage by pressing on nerves related to hearing and balance.
A usually benign tumor arising from a gland, such as a pituitary adenoma.
Adjunct or adjuvant treatment
One treatment given in addition to another. The treatments work together to make each more effective.
A weak point in a blood vessel, such as an artery or vein, which may then blow up like a balloon. The danger is of the aneurysm bursting and bleeding into the brain, which causes a stroke.
This procedure uses X-rays to produce pictures of arteries or veins by injecting a dye (contrast material) into the arteries or veins and "filming" it as it passes through the blood vessels.
Loss of ability to speak or write; loss of ability to understand speech or written words.
Arteriovenous malformation (AVMs)
A tangle of blood vessels in the brain.
A brain tumor arising in the supportive tissue of the brain. They are the most common primary CNS tumors, representing about half of all primary brain and spinal cord tumors.
Masses of nerve cells deep within the brain at the base of cerebral hemispheres.
Not malignant, not cancerous.
Occurring on both sides of the body.
A tumor whose cells have embryonic characteristics, fast-growing and invasive.
In radiation therapy, the use of implants of radioactive material such as radium, iridium at the site or a short distance from the area being treated.
The bottom-most portion of the brain connecting the cerebrum with the spinal cord. The midbrain, pons, medulla oblongata and reticular formation are all part of the brain stem.
A malignant tumor that arises from skin or the lining of body organs. They often invade adjacent tissue and spread to distant organs, including the brain.
Central nervous system (CNS)
Pertaining to the brain, cranial nerves and spinal cord.
The angle between the cerebellum and the pons, a common site for the growth of acoustic neuromas (vestibular schwanomas).
The second largest area of the brain, consisting of two hemispheres or halves and is connected to the brain stem.
Refers to the cerebrum or cerebral hemispheres.
Swelling of the brain tissue due to an accumulation of fluid which may be caused by tumor, toxic chemicals or interaction.
The clear fluid made in the ventricular cavities of the brain that bathes the brain and spinal cord.
The largest area of the brain occupying the uppermost part of the skull. It consists of two halves called hemispheres. Each half of the cerebrum is further divided into four lobes: frontal, temporal, parietal, and occipital.
A rare, benign tumor arising at the base of the skull, especially in the area near the pituitary gland. It is very slow growing and might be present for a long time before causing any symptoms.
This very rare tumor arises from bone and is composed of cartilage. It is a locally invasive malignant tumor.
A rare, benign, slow growing tumor that occurs at the base of the skull in about 1/3 of patients or at the end of the spine.
This is what produces spinal fluid, which flows through the ventricles and meninges surrounding the brain and spinal cord.
Circumscribed or encapsulated
Localized; having a border or being wholly confined to a specific area.
Images in three dimensions to the shape of the tumor.
Existing before or at birth.
Circular In scans, an image from the top of a thin layer of the brain showing both the right and left sides.
12 pairs of nerves having their origin in the brain.
A benign tumor arising from small nests of cells located near the pituitary stalk.
Surgery involving the removal of skull bone to gain access to the brain and the bone is put back at the end of the operation.
Computed Tomography. Also known as a "CAT scan". A sophisticated procedure using X-rays to produce computerized images through the body.
A fluid-filled mass, usually enclosed by a membrane.
Lacking a distinct border, spread out, not localized.
Measurement of doses.
Tissue swelling caused by the accumulation of fluid.
Able to achieve the desired results or produces beneficial results.
Localized. Refers to a tumor that is wholly confined to a specific area, surrounded by a capsule.
Tending to occur repeatedly in family members, but is not genetic (inherited). Might indicate a susceptibility, or a common environmental influence.
The process of spreading the total required treatment dose over an extended period of time.
Limited to one specific area.
FSR or SRT (Fractionated Stereotactic Radiotherapy)
A moderately high dose radiation treatment usually received over three to eight sessions.
A mass of nerve tissue or a group of nerve cell bodies.
The supportive tissue of the brain. The most common cells are astrocytes and oligodendrocytes. Unlike nerves, glial can reproduce itself. Glial is the origin of the largest percentage of brain tumors.
Glioblastoma Multiforme (GBM)
A malignant tumor which commonly invades adjacent tissue and spreads throughout the CNS. This is usually a fast growing tumor containing a mixture of cell types.
Any tumor arising from glial tissue of the brain, which provides energy, nutrients and other support for nerve cells in the brain.
A very rare, slow growing, benign tumor that invades the temporal bone.
A unit of absorbed radiation.
A benign tumor-like mass arising from blood vessels and is often cystic. It is often associated with von Hippel-Lindau disease.
A rare tumor, grade II or grade III, different from the meningioma, although rising from the same cells.
Muscle weakness of one side of the body.
Complete paralysis of one side of the body.
Inherited or genetic; passed on from parent to child.
An increased number of smaller dosage treatments of radiation therapy.
Part of the wall of the third ventricle and at the base of the optic chiasm.
Use of the body's immune system to fight tumors.
IMRT (Intensity Modulated Radiation Therapy)
The intensity of the radiation can be changed during treatment to spare adjoining normal tissue and increase the dose to the tumor.
Penetrating normal, surrounding tissue.
Below the tentorium, a flap of the membrane protecting the brain that separates the cerebral hemispheres from the brain structures in the posterior fossa.
Implantation of radioactive seeds into a tumor.
Treatment delivered into the space created when the brain tumor was removed.
Located within the cerebral hemispheres.
Within the skull.
Injection into a ventricle. There are four ventricles or cavities in the brain, which are filled with cerebrospinal fluid and linked by ducts so the fluid can circulate.
Refers to a tumor that invades healthy tissues; also called diffuse or infiltrating.
Radiation therapy; treatment by ionizing radiation.
In radiation, to have equal doses of radiation in different areas.
A change in tissue structure due to injury or disease.
Radiosurgery given by a device producing powerful X-rays, which is normally used to give conventional radiotherapy. The unit is modified by bolting on a collimator which focuses the beam down to a few millimeters in width. Treatment with this equipment tends not to be as accurate as using stereostatic radiosurgery, computer-guided treatment specifically designed to deliver radiation to very specific regions of the brain.
A rare, benign tumor composed of fat tissue, commonly located in the corpus callosum.
In the area of the tumor; confined to one specific area.
Cancerous or life-threatening, tending to become progressively worse.
Damage to the brain due to the bulk of a tumor, the blockage of fluid, and/or excess accumulation of fluid within the skull.
Median means the middle value. An equal number of people live longer as die earlier than the median.
Fast-growing, invasive tumors located in the cerebellum that frequently spread to other parts of the central nervous system via the spinal fluid.
Thin layer of tissue covering a surface, lining a body cavity, or dividing a space or organ.
They are three, thin membranes that completely cover the brain and the spinal cord. Spinal fluid flows in the space between two of the membranes.
A brain tumor arising from the fibrous tissues that cover the brain's surface and spinal cord.
In cancer patients, the spreading of malignant cells.
Delicate surgery involving the use of a special microscope and small instruments.
Complications directly resulting from treatment.
MRI Scan (Magnetic Resonance Imaging)
A scanning device that uses a magnetic field, radio waves, and a computer. Signals emitted by normal and diseased tissue during the scans are assembled into an image.
A tumor, either benign or malignant.
The entire integrated system of nerve tissue in the body: the brain, brain stem, spinal cord, nerves and ganglia.
The region of the embryo that eventually develops into the nervous system.
The branch of medicine that deals with the use of radioisotopes in therapy and diagnosis.
Caring for a patient by maintaining the best quality of remaining life.
PET Scan (Positron Emission Tomography)
A special type of X-ray using a radioactive dye which shows areas of the brain that have a higher or lower metabolism than normal. It can sometimes be used when an MRI scan alone is inconclusive. This is a limited-use diagnostic tool.
Photodynamic Radiation Therapy (PRT)
A light sensitive drug is given through a vein and concentrates in the tumor. During a surgical procedure, a special light activates the drug which kills the tumor cells.
Lies below the corpus callosum that produces the hormone melatonin. Melatonin is believed to control the biological rhythms of the body.
Composed of two lobes (anterior and posterior). Attached to and receives messages from the hypothalamus. Several hormones are produced by the pituitary including prolactin, corticotropin, and growth hormone.
Part of the brain stem, containing the origins of the 5th, 6th, 7th and 8th cranial nerves.
Primitive Neuroectodermal Tumor (PNET)
A tumor which appears identical under the microscope to the medulloblastoma, but occurs primarily in the cerebrum and most frequently occurs in very young children.
An outline of care; a treatment plan.
The use of radiation to destroy cancer or other abnormal cells in the body. During radiation therapy, a significant amount of healthy normal tissue is irradiated. To reduce the side effects caused by this, the radiation dose is split into a number of treatments, in theory enabling the normal healthy tissue to recover before the next treatment is given.
Resistant to radiation therapy.
Responsive to radiation therapy.
Use of a number of precisely aimed, highly focused beams of ionizing radiation to target a specific area.
The return of symptoms or the tumor itself.
Surgical removal of a tumor.
Tumor remaining after surgery.
The saddle-shaped, hollowed extension of the sphenoid bone that contains the pituitary gland.
The full disease process.
SRS (Stereotactic radiosurgery)
A one-session treatment with high dose focal radiation within the brain.
A method of precisely locating areas in space utilizing 3-dimensional mapping, especially in the areas of the brain.
Medications used to decrease swelling around tumors.
Buzzing or ringing in the ear.
An inflammatory or degenerative condition of the fifth cranial nerve characterized by severe pain in the face.
A generalized infection of the central nervous system caused by a small parasite.
An abnormal growth.
Relating to blood vessels.
The blood supply of a tumor.
(also known as an acoustic tumor or neuromas) a benign tumor of the eighth cranial nerve, which supplies the ear.
XRT (Conventional external beam radiation therapy)
Small amounts of external beam radiation therapy given over an area to eliminate stray cells and future growth.
Frequently Asked Questions
A single, high dose of radiation acts like the surgeon's scalpel, eradicating the diseased area with a safe and effective approach. The patient wears a light weight head frame that attaches to a helmet, through which radiation is precisely focused at a single target. Only the tissue being treated receives a very strong dose of radiation while the surrounding tissue remains unharmed. The painless, bloodless procedure is usually performed under local anesthesia with mild sedation. Although the entire procedure takes several hours, the actual treatment takes just 15 minutes to one hour, depending on the size of the lesion being treated. If there are multiple tumors or if the tumor spreads to another area, radiosurgery can be repeated. There is minimal risk of surgical complications like infection, hemorrhage or leakage of cerebral spinal fluid.
- It can be used in conjunction with conventional surgery as a boost and can be used in previously inoperable cases.
- For some patients with brain tumors and vascular malformations, it can be used in place of brain surgery.An individual who would be at risk for complications by conventional surgery may be a candidate for stereotactic radiosurgery.
- It can be used when prior surgery or radiation therapy has failed to control the disease process.
- The treatment is 30-70% less than the cost of alternate treatment modalities, including traditional open skull surgery.
- It is bloodless, virtually painless, no loss of hair with rapid return to activities of everyday living.
- Excellent, well-documented clinical outcomes.
Potential candidates are reviewed by a multi-disciplinary panel of professionals for the following:
- Medical history
- Clinical examinations
- Imaging studies
- Previous surgeries and treatments
Conditions for which this treatment is considered include:
- Malignant gliomas
- Acoustic neuromas
- Pituitary tumors
- Low grade glioma and skull-based tumors
It can be an effective treatment for vascular malformations such as arteriovenous malformations cavernous angiomas And it can treat functional disorders such as trigeminal neuralgia, Parkinson’s disease and essential tremors.
- Medical and Surgical History
- Clinical Examinations
- Imaging Studies, such as MRI and CT and PET scans
- Function Studies
On the day of treatment, the patient will have a lightweight frame attached to the head. Local anesthesia is used before the frame is secured in place. The frame is used in conjunction with an imaging procedure to accurately locate the diseased area. With the frame in place, the patient either has an MRI or CT imaging study or, in the case of an arteriovenous malformation (AVM), angiography, in order to precisely locate the diseased area to be treated. Data from the imaging study is transferred into the treatment planning computer. While the patient rests, the treatment team (which consists of a neurosurgeon, radiation oncologist and physicist) uses advanced software to determine the treatment plan. This takes one or two hours to complete depending on the complexity and location of the disease. When the individual treatment plan is completed, the patient is placed on the Gamma Knife couch and precisely positioned. The patient is then moved automatically, head first into the machine, and treatment begins. Treatment typically lasts from 15 minutes to an hour, during which time the patient feels nothing unusual. At the completion of the treatment, the patient is automatically moved out of the machine, and the head frame is removed. The patient may remain in the hospital overnight for observation.
The patient remains conscious throughout the entire procedure, and may communicate with the treatment team.