Brain Surgery for the 21st Century
By Ann S. Boor
Brain surgery. These two words are certain
to strike fear in even the bravest of patients. But
new advances in brain surgery have eliminated some of
the anxiety as well as much of the pain and recovery
time. Alternatives to traditional "open brain"
surgery are available in forms of stereotactic radiosurgery
and stereotactic neurosurgery. And, a diagnosis of brain
tumor or brain cancer will no longer seem as frightening.
The Photon Knife
On Tuesday morning, a 10-year-old girl had what was
considered to be an inoperable brain tumor. By Wednesday
afternoon, the tumor was completely destroyed, the girl
went home with her parents and she got to keep all of
her pretty, long hair.
"Sound like a miracle? A medical miracle,"
says Robert Behar, M.D., of the Stereotactic Radiology
Center at Spring Branch Medical Center. "Her tumor
was eradicated by a revolutionary new method of non-invasive
stereo radiosurgery -- otherwise known as the photon
The photon knife is a new, minimally invasive type of
brain surgery used to treat and wipe out brain tumors
and other abnormalities.
"With this procedure, we do not need to shave the
patient's hair or open the skull," says Dr. Behar.
"The photon knife is a precise way to deposit a
very intense dose of radiation in the brain to an area
that's been localized, well defined and immobilized."
The advanced computer software of the photon knife allows
it to deliver up to eight weeks of radiation therapy
to an area as small as 4 millimeters in 20 minutes.
One of the advantages of the photon knife is that it
delivers the radiation to the part of the brain that
needs treatment. Unlike external radiation, the photon
knife restricts the radiation delivery to the affected
part of the brain and basically ignores the healthy
"Stereotactic radiosurgery has a number of applications,"
says Dr. Behar. "Malignant tumors is one such area.
We have also had tremendous success in treating malformations."
"At Spring Branch, we have also pioneered the use
of the photon knife in treating acoustic neuromas,"
continues Dr. Behar. "These are tumors that affect
the part of the brain responsible for hearing and balance.
Traditionally, they have been treated with a surgery
with a significant chance of causing hearing loss and
facial paralysis on the affected side. At Spring Branch,
we have taken the lead in delivering the radiosurgery
over three separate sessions separated by eight to 12
hours. This has resulted in a much lower chance of injuring
our patients' hearing and facial functions."
Prior to the development of the photon knife, an open
brain operation would have involved weeks of hospitalization.
The recuperation period would be lengthy, and follow-up
treatment may have included radiation.
On the other hand, stereotactic neurosurgery is performed
under local anesthesia and often on an outpatient basis.
There are little or no side effects. Patients resume
their normal activities immediately and can usually
return to work the next day. It may all sound so simple,
but don't be fooled, advises Dr. Behar. "This is
an extremely sophisticated procedure that calls for
special training and state-of-the-art technology. Altogether,
it is an excellent alternative to conventional surgery.