Gamma Knife® Surgery Frequently Asked Questions

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What is Gamma Knife® surgery?

Gamma Knife® surgery is a proven treatment method used to treat cancerous and non-cancerous tumors of the brain. The Leksell Gamma Knife® isn’t actually a knife. Your doctor will not make any incisions in your head. Instead, very precisely-focused beams of radiation are targeted to the area of the brain that needs to be treated. The treatment is painless and simple.

In Greater Cincinnati, this care is provided by the medical staff of The Jewish Hospital – Mercy Health, who are experienced in the full range of cancer care from chemotherapy to bone marrow transplant to specialized radiation procedures such Gamma Knife® radiosurgery.

How does Gamma Knife® surgery work?

Gamma Knife® surgery is a unique treatment method that delivers highly-focused radiation beams to specific targets in the brain. The Gamma Knife® uses 192 individual radiation beams that converge into one focal point. The radiation source used is called cobalt. These sources are positioned in a half-circle around the head so that all of the beams can focus on a single point in the brain. The shape and dose of the radiation is carefully optimized to hit only the target, without damaging healthy tissue.

What are the treatment steps?

Gamma Knife® surgery consists of five steps: preparing for treatment, attaching the head frame, imaging, treatment planning and treatment delivery.

What happens before the treatment?

Before the treatment, your experienced healthcare team at The Jewish Hospital will explain the entire procedure to you. Gamma Knife® surgery does not require us to cut or shave your hair. After we explain the procedure, we will fit the head frame on you.

What is the head frame?

An important part in Gamma Knife® surgery is the stereotactic head frame. The frame allows the physician to accurately pinpoint the target that will be treated in your brain. This lightweight frame is attached to your head with four screws and ensures that the radiation beams can be precisely targeted. The frame also prevents your head from moving during imaging and treatment procedures. You will receive a combination of local anesthetic and intravenous sedation for the frame placement.

What kind of imaging is performed during Gamma Knife® surgery?

After we place the head frame, the next step is to perform imaging such as magnetic resonance imaging (MRI), computed tomography (CT) or angiography.

This imaging is required so that your team can determine the exact size, shape and position of the target in the brain.

During imaging, a coordinate box is placed on the head frame to provide reference points on the images for the treatment plan. After imaging, the coordinate box is removed.

How will my physician determine my treatment plan?

Once imaging has been completed, you can rest while your physician develops a very precise and accurate treatment plan.

No two treatment plans are alike. Every patient’s plan is individually developed to address his or her specific medical condition. Your radiation oncologist and neurosurgeon will work together to design the plan and calculate how your treatment will be performed. This usually takes 1-2 hours.

What can I expect during treatment?

The final step in Gamma Knife® surgery is the actual treatment. When the treatment plan is complete, you will lie down on the treatment bed and the head frame will be attached to the table.

You will be awake during the procedure and able to communicate with your care team and physician through an audio and video connection. When treatment begins, the bed will move into the dome section of the Gamma Knife® unit. The treatment is silent and totally painless. Most patients are able to listen to music during the treatment.

We monitor the procedure at all times. The treatment will last several minutes up to 1-3 hours, depending on the size and shape of the target.

What happens after the treatment?

When your treatment ends, the head frame will be removed. Some patients experience a mild headache or minor swelling where the head frame was attached, but most report no problems. You should be able to return to your normal activities within a day or so.

What kind of follow-up can I expect?

The benefit of your Gamma Knife® treatment will occur over time. Radiosurgery is designed to stop the growth of tumors or lesions, which means that the effect will be seen over a period of weeks or months. Your physician will stay in contact with you to assess your progress, which will include follow-up CT, MRI or angiography imaging, and office visits.

We invite you to learn more about Gamma Knife® as a treatment option, and let us know if you have questions contact Amy Richards Lusk, RN by phone at 513-686-5972 or by email at