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Vascular malformations of the brain
A guide for patients and carers
What is stereotactic radiosurgery?
Stereotactic radiosurgery is a single treatment of invisible, high-energy x-ray radiation, delivered by a machine called a ‘linear accelerator’ or ‘gamma knife’. It is designed to target a high dose of radiation at your vascular malformation, and minimise the amount delivered to the normal brain around it and the rest of your body. Despite its name, it is not a surgical operation, and does not involve any incisions.
What happens before radiosurgery?
A team of professionals from several different departments in the hospital will look after you. The main people involved will be a radiotherapist, neuroradiologist, radiographer and physicist, and perhaps a neurologist or neurosurgeon.
Careful planning is needed to aim the narrow x-ray beams precisely. Because your head must be kept very still in a frame during linear accelerator radiosurgery, the staff will need to make an impression of your teeth and the back of your head long before the treatment. You may need to have a dental check-up beforehand.
You may need to have some further scans of your head before the treatment. These will provide detailed computer images of your brain for the radiotherapist and physicist to use to direct the x-ray beams accurately.
What happens during radiosurgery?
When you attend for your treatment, your customised head frame will be fitted. Its measurements will be re-checked and x-ray pictures will be taken again to confirm its exact position. You will then lie on a couch, which supports your head and the frame. The radiographers will set up the positions of the couch and the treatment unit. The radiosurgery will last between 40 minutes and one hour, during which time you should not feel any discomfort, but you will hear the noise of the x-ray unit.
What will happen after radiosurgery?
After the treatment, it can take two years or more for the vascular malformation to seal up and disappear, during which time you are still at risk of the problems that vascular malformations can cause. After this time, your doctors may want to repeat an angiogram or MRI scan to see how effective the treatment has been.
The advantages of radiosurgery are that it does not involve a craniotomy, or a general anaesthetic, and that it can treat some deep malformations. However, it cannot normally be used to treat malformations larger than three centimetres; it can take two years or more for protection from further symptoms; and there is a risk of damage to the surrounding brain, called radionecrosis.
A team of professionals from several different departments in the hospital will look after you. The main people involved will be a radiotherapist, neuroradiologist, radiographer and physicist, and perhaps a neurologist or neurosurgeon.
Careful planning is needed to aim the narrow x-ray beams precisely. Because your head must be kept very still in a frame during linear accelerator radiosurgery, the staff will need to make an impression of your teeth and the back of your head long before the treatment. You may need to have a dental check-up beforehand.
You may need to have some further scans of your head before the treatment. These will provide detailed computer images of your brain for the radiotherapist and physicist to use to direct the x-ray beams accurately.
What happens during radiosurgery?
When you attend for your treatment, your customised head frame will be fitted. Its measurements will be re-checked and x-ray pictures will be taken again to confirm its exact position. You will then lie on a couch, which supports your head and the frame. The radiographers will set up the positions of the couch and the treatment unit. The radiosurgery will last between 40 minutes and one hour, during which time you should not feel any discomfort, but you will hear the noise of the x-ray unit.
What will happen after radiosurgery?
After the treatment, it can take two years or more for the vascular malformation to seal up and disappear, during which time you are still at risk of the problems that vascular malformations can cause. After this time, your doctors may want to repeat an angiogram or MRI scan to see how effective the treatment has been.
The advantages of radiosurgery are that it does not involve a craniotomy, or a general anaesthetic, and that it can treat some deep malformations. However, it cannot normally be used to treat malformations larger than three centimetres; it can take two years or more for protection from further symptoms; and there is a risk of damage to the surrounding brain, called radionecrosis.
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Page 11 of 15
Contents
- Introduction
- What is a vascular malformation of the brain?
- Arteriovenous malformation (AVM)
- Cavernous malformation
- Venous malformation
- What tests will the doctors do?
- What are the symptoms of a vascular malformation?
- What are the risks for the future?
- How can vascular malformations be treated?
- What is embolisation?
- What is stereotactic radiosurgery?
- What is neurosurgery?
- What other treatments might I have?
- How will my life be affected?
- Other organisations that may be able to help
