Pediatric neurosurgery is a field that focuses on brain-related conditions caused by injury, illness, congenital abnormalities, or developmental anomalies. The surgical procedures that fall under this umbrella target different structures in the developing brain. Operating on such delicate and crucial structures carries a higher than normal risk of surgical complication. For this reason, pediatric neurosurgery requires a steady, dexterous and precise hand.
Still, a high skill level does not eliminate the morbidity of incisions and stitches at the surgical site. That is why medical advances keep creating newer, minimally invasive ways of performing neurosurgery. Like the gamma knife, for example.
The gamma knife and its role in pediatric neurosurgery
A gamma knife is not an actual, physical surgical scalpel. As the name implies, it is a device that employs gamma rays to target problematic tissue or blood vessels inside the brain. This eliminates the need to physically open up a patient’s brain in order to reach the part that needs treatment.
There are many reasons why neurosurgeons prefer gamma knife surgery to conventional neurosurgery. For starters, no incisions, excisions and sutures are needed. This means no head shaving, no blood, no wound and no regular change of dressing. It also means no post-surgery recovery. The procedure is also very precise and only targets the brain tissue or vasculature with the problem. This lowers the risks typically associated with brain surgery.
Physically, the gamma knife setup looks nothing like a knife or scalpel. It looks more like a small medical imaging machine, or a super-small radiotherapy machine. In fact, it is a little bit of both.
How a gamma knife works
A gamma knife is a device that administers stereotactic radiation therapy/surgery. Stereotactic surgery is the use of ultra-thin, precisely aimed beams of radiation to target problem tissue in the brain. A gamma knife consists of a brace that keeps the head immobile during treatment, and a head frame, which directs radiation toward the target area of the brain.
First, the surgeon applies a topical anesthetic to the skin where the screws of the head brace rest. They place the brace on the patient’s head and fasten the screw. With the patient’s head immobilized, the neurosurgeon will oversee the medical imaging. They will use the resulting images to plan how to direct the radiation toward the target area in the brain. The planning is done using special software that maps out the target and calculates how the radiation is to hit the target without hitting adjacent tissue.
Finally, the patient undergoes the radio-surgical procedure. The patient lies down on a procedure couch positioned right in front of the head frame. The doctor then attaches the head brace to the frame, which keeps the patient’s head immobilized for the duration of the procedure. The head frame directs multiple rays of gamma radiation toward a single target in the brain. The head frame knows exactly where to point the rays because it gets precise 3D coordinates by the software that the neurosurgeon uses to plan the radiosurgery.
The entire process typically takes anywhere from a couple of minutes to a few hours. Stereotactic surgery is typically used on targets that are only a few millimeters wide, and no more.
Find out if a gamma knife can help your child
The uses of the gamma knife are varied. The device is used to target and dissolve (sometimes) hard-to-reach tumors, removing the need to physically cut the tumor out. It is also used to treat malformed or distressed blood vessels. A gamma knife can also treat brain lesions and damaged nerves that cause conditions ranging from neuralgia to epilepsy. Your pediatric neurosurgeon specializes in treating neurological conditions in young children. Get in touch to find out how they can use pediatric neurosurgery to help your child.
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