WHAT EVERY PATIENT NEEDS TO KNOW... YOUR GAMMA KNIFE PROCEDURE

PREPARING FOR RADIOSURGERY
When arriving at the Long Island Gamma Knife Center at South Nassau Communities Hospital, make sure you bring any prescription medications that you will need for that day, as well as a list of medications that you are allergic to.

The evening before your treatment, you should wash your hair and avoid using any hair cream or sprays.

Heart or blood pressure medications should be taken with a small sip of water the morning of your procedure.

Remember! Do Not eat or drink anything after midnight.

THE DAY OF GAMMA KNIFE SURGERY
Arrive at the Washington Avenue entrance (just east of the hospital) to Radiation Oncology and park in the designated spaces. If no space is available, find any space and a parking pass will be provided. Your Gamma Knife nurse will meet you in the waiting room to escort you to the MRI Suite, where you will change into a hospital gown. Before changing, make sure you remove:

• All jewelry • Buckles, hairpins • Wigs or hairpieces.

PREPARATION
In preparation for the procedure, a guiding device or stereotactic frame will be fixed firmly onto your head. The-stereotactic frame is a rectangular ring that fits over your head, to which four metal posts are attached.

After the skin has been cleansed with alcohol and a local anesthesia "numbs" the area, four pins are attached to your skull. Any discomfort you feel during the placement of the pins will last only a few seconds. The remaining tests and treatment will be pain free.

The stereotactic frame will remain on your head until after the completion of the Gamma Knife treatment.

IMAGING BEFORE THE PROCEDURE
Each patient's needs are different, but to help the surgeon plan your treatment, you will undergo imaging studies, such as:

• MRI • Angiogram • Computerized Tomography (CT)

In addition, a clear plastic helmet with many holes in it will be placed on your head over the frame to measure the size of your head. This is usually done prior to your imaging study and only takes a few moments.

THE GAMMA KNIFE PROCEDURE
After your treatment plan has been finalized, you will be taken into the Gamma Knife treatment room and transferred onto the treatment couch where the stereotactic frame will be connected to a device
known as a collimator helmet. The helmet has 201 holes through which the radiation beams will pass.

The treatment begins when the doors of the radiation unit open and the head of the couch moves into position. You will hear a small click as the collimator helmet engages with the machine, you will not hear or feel the treatment.

During this time you will remain in constant contact with the Gamma Knife personnel via the use of an intercom system. Your treatment is observed at all times through television monitors. When the treatment is completed, the Gamma Knife couch will move back into its starting position.

State-of-the-Art Gamma Knife Equipment

AFTER YOUR TREATMENT
When your treatment is completed, the frame will be removed, an antibiotic ointment will be applied along with a pressure dressing. Band-Aids will be placed on the pin sites prior to discharge from the unit.

On rare occasions, there may be bleeding at a pin site that does not stop with pressure from the gauze. Should this occur, your doctor will use a stitch to close the pin site.

When you are able to take fluids by mouth, the nurse will remove your IV line.

SIDE EFFECTS
The Gamma Knife is accurate to .3 millimeters. You should have very few side effects because only the abnormality is targeted; the surrounding brain tissue receives a minimal dose of radiation.

You may experience a headache after the Gamma Knife treatment. Should this occur, your nurse can give you medications ordered by your doctor.

Although rare, there are some long term risks after Gamma Knife surgery, depending on the size, shape the particular problem. If any of the following occur, contact your physician immediately!

• Seizure • New onset of numbness • Weakness
• Loss of balance • Visual disturbance • Severe headache

DISCHARGE INSTRUCTIONS
Most patients will be able to leave LI Gamma Knife unit after a period of observation. If needed you may be admitted to South Nassau overnight.

Your follow-up care will be coordinated with the doctor who referred you and the doctors involved in your treatment. If you are discharged the day your procedure was performed, you should have a
family member drive you home and stay with you for that night.

You may resume your normal diet and activities as tolerated. Medications prescribed by your doctor before the Gamma Knife treatment should be resumed, unless your doctor tells you otherwise.

You may gently shampoo your hair the day after treatment; however, avoid scrubbing the pin sites until they have healed for a week or so. Occasionally, patients note some persistent numbness or tingling of the scalp. The feeling is temporary and is usually gone within a few weeks.

Please call your physician or your Gamma Knife nurse if you have any questions about your treatment.

For additional information on Neurological Surgery’s Gamma Knife Procedure, please call (516) 255-9031.