Gamma Knife Surgery

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Despite its name, there’s no knife involved in Gamma Knife surgery.

Instead, this minimally invasive procedure uses targeted, high-energy radiation therapy to pinpoint and destroy brain tumors and lesions or keep them from growing. And it won’t hurt nearby healthy brain tissue.

Cleveland Clinic’s neurosurgeons and radiation oncologists are experts at Gamma Knife surgery — which is considered a gold standard treatment. If your provider has recommended this procedure, you can feel confident that you’re in capable hands with us.

Why Choose Cleveland Clinic for Gamma Knife Surgery?

Industry leaders:

Cleveland Clinic is the first in the United States and third in the world to offer the novel Elekta Esprit Gamma Knife machine. This cutting-edge equipment offers both frame-based and mask-based options to help you stay still and comfortable during treatment. We’re also the first in the nation to offer the revolutionary open-face Leksell® Vantage™ head frame.

Collaborative care:

Our board-certified and fellowship-trained team includes neurosurgeons, neurologists, neuro-oncologists and radiation oncologists. We share information and expertise with each other to make sure you have the most accurate diagnosis and the best treatment options. Meet our team.

Demonstrated expertise:

We’ve treated thousands of people with Gamma Knife and continually treat hundreds each year, making us one of the busiest healthcare systems in the nation to use this safe, minimally-invasive procedure. Our experience gives us the deep expertise to teach neurosurgeons and radiation oncologists worldwide how to use Gamma Knife.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Conditions We Treat with Gamma Knife Surgery at Cleveland Clinic

Our specialists use Gamma Knife surgery to treat several brain conditions, including:

Acoustic neuroma, a noncancerous tumor that affects balance and hearing.
Arteriovenous malformation (AVM), a snarled tangle of blood vessels.
Cancerous and noncancerous brain tumors, like brain metastases, pituitary adenomas and more.
Tremors, from conditions like essential tremor or Parkinson’s disease.
Trigeminal neuralgia, a chronic (ongoing) condition that causes extreme face pain.
Some types of epilepsy.

We may also use Gamma Knife to help treat brain lesions in hard-to-reach places and to help:

Keep blood from flowing through misshapen blood vessels.
Prevent cancer from spreading.
Stop nerves from sending impulses.
Stop tumors from growing again after brain surgery.

Providers Who Perform Gamma Knife Radiosurgery

Locations

Our healthcare providers see patients at Cleveland Clinic's Main Campus and Akron General Medical Outpatient Center.

Gamma Knife Surgery at Cleveland Clinic

When appropriate, our experts use Gamma Knife surgery to treat brain lesions with pinpoint accuracy. This precision-targeting treatment spares healthy brain tissue and reduces the likelihood of side effects while treating the underlying condition with very high success rates. With Gamma Knife, we can treat many simultaneous brain lesions in a single session.

Before we recommend Gamma Knife surgery, your neurosurgeon will take a complete medical history and do a physical exam. We may recommend Gamma Knife if you:

Have health conditions that would make brain surgery challenging.
Have multiple lesions or tumors.

Preparing for surgery

There are a few things you’ll need to do to prepare for Gamma Knife surgery:

If you’re having Gamma Knife for AVM, you shouldn’t eat or drink anything after midnight the night before the surgery.
Take your morning medications with sips of water the morning of surgery. And bring all your medications (including inhalers) with you.
Wash your scalp the night before surgery and wear your hair loose without clips, pins or bands the day of surgery (your head won’t be shaved).
Wear comfortable clothes (nothing that needs to go over your head) and slip-on shoes.
Make sure you have a family member or friend that can drive you to surgery and take you home afterward.

What to expect the day of surgery

Plan to spend the whole day with us when you arrive for Gamma Knife surgery. The first thing you’ll do is meet with your care team. They’ll ask about any medications you take, any allergies you have and if you have any medical devices in your body (like a pacemaker).

Before the procedure, we may put an IV into a vein in your arm. The IV sends a dye into your body to make tumors and brain tissue easier to see. If you’ve already had an MRI a few days before surgery, then you won’t need this step. We’ll just give you an oral medication to relax you.

Now it’s time for surgery. There are two options to help us target the radiation:

Frame-based surgery

We numb four spots on your head with a local anesthetic/numbing medication. Then we attach a lightweight frame to your head with special pins (this doesn’t hurt). This frame lets us pinpoint the exact area in your brain to treat with radiation. Then we may we take pictures of your brain using:

We review these pictures and use them to help plan your precise, personalized treatment.

Mask-based (frameless) surgery

Before your treatment, you’ll lie down on the treatment table, and we’ll make a custom mask by warming up a piece of lightweight, breathable mesh and placing it over your forehead, eyes, cheeks and chin so it molds to fit your face perfectly. This doesn’t hurt. It’s not hot — just comfortably warm. The nose area is cut out so you can breathe easily. On treatment day, you’ll wear this mask. The mask serves the same purpose as a head frame. It helps keep your head steady during the procedure so we can target the areas for treatment with complete precision.

Staged radiosurgery

If you have large brain metastases (tumors), your neurosurgeon may recommend staged radiosurgery. The Gamma Knife process is the same, but we use a smaller dose of radiation to treat the lesions and have you return in a month for another treatment.

Taking the Next Step

Gamma Knife surgery can make facing brain surgery a little less unsettling. This minimally invasive procedure takes knives out of the picture (despite its name). It’s a safe, effective and painless way to help shrink or destroy a brain tumor or lesion, or to keep it from growing. Cleveland Clinic specialists are Gamma Knife surgery experts. If you need this treatment, we’re ready.