Gamma Knife

What is Gamma Knife® radiosurgery?

Gamma Knife - a form of stereotactic radiosurgery - is one of the most advanced treatments for brain disorders. This non-invasive procedure delivers a single, high dose of radiation (192 narrow beams) to a very small target without making an incision and without affecting healthy surrounding tissue. It works by destroying cells so that they don't grow, shrinking the size of a lesion or tumor over time.

Gamma Knife is extremely accurate and has an outstanding track record. It allows very small targets deep within the brain to be treated with extremely high precision. Around 70,000 patients undergo Gamma Knife procedures each year at hundreds of leading hospitals and clinics around the world.

There are more than 130 Gamma Knife treatment centers in the United States, but Vidant Medical Center is one of only two in North Carolina. We are the only site east of Winston-Salem. Vidant Medical Center uses the Leksell Gamma Knife® Perfexion™ machine, which features best-in-class radiation protection and comfort for patients and staff. Our highly experienced and specially trained team has performed more than 1,300 Gamma Knife procedures since 2005, when we began offering this effective alternative to traditional brain surgery and whole brain radiation therapy.

Why might I need Gamma Knife radiosurgery?

Gamma Knife is most often used to treat:


Your doctor may have other reasons for recommending Gamma Knife surgery. It may be used when a brain lesion can’t be reached by standard surgery, or when a patient isn't suited for traditional open-brain surgery. The effects of Gamma Knife occur slowly over time, so it’s not for patients who need immediate results.

How does Gamma Knife compare to traditional whole brain radiation therapy?

  • Gamma Knife makes it easy to reach and treat a large number of tumors in a single session.
  • It is especially useful for patients with tumors such as renal cell carcinoma and melanoma, which are less responsive to conventional radiation therapy.
  • Gamma Knife is less toxic and better tolerated than traditional radiation therapy. It is almost always performed as an outpatient procedure and there are generally few side effects.
  • Recovery time is minimal, which means less time lost from work and other activities.
  • Gamma Knife may cost less than traditional radiation therapy or microsurgery.

The Gamma Knife team

Gamma Knife treatment is performed by a team of medical professionals, including neurosurgeons, radiation oncologists, medical physicists, specially trained nurses and others as needed. These experts work together to develop an individualized treatment plan that is right for you.

How should I prepare for Gamma Knife treatment?

  • Do not eat or drink anything after midnight the evening before your procedure.
  • Try to get plenty of rest the night before treatment.
  • Take your morning medications with only a sip of water. Bring all of your medications with you.
  • Wear comfortable clothes. Do not wear any metal objects, including jewelry, body piercings or underwire bras.
  • Feel free to bring reading materials, crafts or other items to help pass the time surrounding your treatment.
  • You may bring music to listen to during your treatment. A CD player is available.

What happens during Gamma Knife treatment?

  • An intraveous (IV) line may be put into your arm or hand.
  • Head frame placement. A lightweight box-shaped frame is attached to your head to keep it from moving and to position it in the precise location for your treatment. Special pins are used to attach the frame. Our staff will clean the sites for the pin placement on the front and back of your head with an antiseptic. You will receive four injections of a local anesthetic at the pin sites to numb the skin before the pins are inserted. You may feel some pressure as the pins are tightened, but no pain.
  • Measurements. After the head frame is positioned, a box used to measure skull depth will be placed on top of the frame. Measurements of your head are taken that will be used for planning your treatment.
  • Imaging procedure. To determine the exact location of the tumor or lesion, you will have an MRI or CT scan. Occasionally, this may be done with a cerebral angiogram.
  • Treatment planning. The radiation therapy team will use the “real time” measurements and images to determine your radiation dose, exactly which area(s) to treat and how to target the area for the best results. This is done using special computer software and can take up to 90 minutes.
  • Radiation treatment. When it is time for your treatment, you will be brought into the Gamma Knife room and helped onto the Gamma knife couch. Your head frame will be attached to a positioning system that automatically moves your head during treatment. The treatment is silent and totally painless and will usually last between 30-60 minutes. You will be monitored visually during the entire treatment time, and you can talk with your care team through a microphone in the machine.

What happens after the Gamma Knife procedure?

  • After your treatment is completed, the head frame will be removed. The pin sites will be covered with antibiotic ointment and small bandages.
  • You will be observed for about an hour, then discharged. You will need someone to drive you home. (In some cases, your treatment may be done as part of an inpatient stay, or you may be kept overnight for observation.)
  • You will be given specific discharge instructions that tell you how to care for your pin sites, what to do when you get home and when to return to see your doctor.
  • You should be able to return to your normal routine in just a day or two.
  • The effects of the treatment will occur over time, with full results being seen after a period of weeks or perhaps months.

What are the side effects of Gamma Knife treatment?

Most people have no side effects, but some people may experience:

  • Swelling around the eyes
  • Infected pin site
  • Headaches
  • Nausea
  • Seizures
  • Weakness
  • Confusion or change in behavior
  • Scar at the pin site

If any of these symptoms occur, call the Gamma Knife staff at 252-847-2611 between 8 am and 5 pm, Monday through Friday. After hours and on weekends, call 252-353-9525 and ask for the neurosurgeon on call.