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Neuroscience (SNI) Blog

'radiosurgery' Neuroscience (SNI) posts

Debilitating Facial Pain May Be Trigeminal Neuralgia

All pain can be frightening, but when patients describe sharp, electric-type pain in their face, the cause may be Trigeminal Neuralgia, a treatable pain syndrome manifesting as unilateral facial pain that can be severe in intensity. The pain occurs in one or more distributions of the trigeminal nerve. The pain usually lasts for several seconds to several minutes followed by periods of being pain free. Trigeminal neuralgia pain can be triggered by sensory stimuli to the face including talking, brushing teeth, eating, and touching the face. In some cases, there is no trigger. The annual incidence of trigeminal neuralgia is approximately 4 in 100,000. The initial workup for trigeminal neuralgia may include an MRI of the brain to rule out brain tumor or MS plaques.

In many cases, trigeminal neuralgia is caused by compression of the facial nerve most commonly by the superior cerebellar artery or the anterior inferior cerebellar artery, although trigeminal neuralgia can be due to compression by a persistent permanent trigeminal artery or odioectatic basilar artery. Other causes of Trigeminal Neuralgia can include demyelinating disease (such as multiple sclerosis) and tumor. In some cases, the cause of Trigeminal Neuralgia is  ...

Life-saving technology and getting the word out about radiosurgery

Twice last week I received phone calls from grateful family members thanking us for taking care of their loved ones when treatment options were dwindling. One patient is now 4 years past his CyberKnife treatment for inoperable lung cancer and is going strong and living life to the fullest. The other patient was recently treated and is feeling great and planning a European vacation. Both families are extremely appreciative for the care they received but both voiced frustration that they stumbled upon this treatment option by chance and that we need to do a better job of publicizing the radiosurgery modalities. As the person receiving these calls, I am thrilled to hear how our center has positively impacted so many lives but struggle with how to get the word out to those who may benefit from radiosurgery in the future. So with our patients’ stories fresh in my mind, here is an introduction to radiosurgery.

Stereotactic radiosurgery is targeted radiation therapy delivered to nearly any body part with precision while utilizing real time image guidance. The ....

Treating Arteriovenous Malformations to Remove the Risk of Rupture

An arteriovenous malformation (AVM) in the brain is a relatively rare condition – occurring in less that 1 percent of the population. It can, however, be neurologically morbid in young adults ages 15 to 20, who are at the greatest risk for hemorrhage and least likely to exhibit symptoms. About 2 to 4 percent of all AVMs each year hemorrhage.

An AVM’s tangled mass of blood vessels, which forms in utero, produces multiple direct connections between arteries and veins without the normal, intervening capillaries. Symptoms often are not present until later in life or until after the AVM ruptures.

A small number of congenital syndromes, such as Sturge-Weber, Rendu-Osler-Weber, ataxia telangiectasia, and Wyburn-Mason, are associated with AVMs. Once formed, extrinsic factors, such as arterial shunting, growth factors and intracranial hemorrhage, may alter the size and shape of an AVM.

The most common types of AVMs are:

International visitors to the Radiosurgery Center

The Swedish Radiosurgery Center was a featured stop for the nursing students from Kobe City College of Nursing during their recent visit to Seattle. The students toured the center where they learned about our CyberKnife and Gamma Knife programs.

I was very impressed that the patient care is personalized to respect the needs of every individual. I have a lot of respect for staff who sincerely work with patients regardless of their background and circumstances. We learned the importance of having confidence in our field as medical professionals and the great privilege of serving ones in need.”

- Keiko Kikuchi, RN, PHN, Assistant Professor, Kobe City College of Nursing.

The group learned ...

Radio-What? Radiosurgery is a treatment that sounds like surgery but isn’t.

If you have never heard the term radiosurgery, you are in good company. This sci-fi sounding word may conjure images from Star Trek but radiosurgery is anything but fiction.

Radiosurgery uses multiple beams of radiation from a variety of directions to destroy diseased or damaged tissue. Although the name sounds like a surgical procedure, this is a non-invasive way to treat many different conditions. The CyberKnife and Gamma Knife technologies are very precise and avoid injury to surrounding, normal tissue and the course of treatment lasts from a single session to less than 2 weeks...

Swedish Expands Radiosurgery Services

There was cause for celebration in the Swedish Radiosurgery Center on Thursday, Dec. 16, as neurosurgeon Ronald Young, M.D. (left), medical director of the Gamma Knife® program, and radiation oncologist Bob Meier, M.D. (below), medical director of the CyberKnife program, treated the center’s first two Gamma Knifepatients. The center, formerly known as the Seattle CyberKnife Center, supports both the Swedish Cancer Institute and the Swedish Neuroscience Institute.

The center has offered CyberKnife services since 2006. This year Swedish installed an Elekta Leksell Perfexion Gamma Knife®, making it one of the most advanced stereotactic radiosurgery centers in the country. CyberKnife can be used to treat cancerous and noncancerous tumors in all areas of the body.

At Swedish, Gamma Knife will be used to treat cancer of the brain and some neurological conditions, such as essential tremor, trigeminal neuralgia and arteriovenous malformations. Providing Swedish neurosurgeons and radiation oncologists access to both of these advanced technologies gives them greater flexibility in selecting the best radiation therapy for their patients. For more information, go to www.swedish.org/radiosurgery or call 206-320-7130.

Gamma Knife Radiosurgery for Treatment of Essential Tremor

Essential tremor (ET) is the most common type of movement disorder, affecting approximate­ly four out of 1000 people, and is significantly more common, though less recognized, than Parkinson’s disease. ET affects men and women equally and is inherited as an autosomal-dominant condition in about 60 percent of cases.

Although often referred to as benign essen­tial tremor, it is hardly benign in patients who may not be able to write legibly, hold a glass of water or use a knife and fork. ET is primarily an action tremor of the upper extremities but may involve resting tremor of the head and neck and/or lower jaw, and also tremor of the voice. The latter may be so severe that speech becomes unintelligible.

Medication and surgical treatment options

Primidone and beta blockers are useful in re­ducing tremor in the early stages of ET, but as the tremor progresses, medical management often becomes less effective or side effects can prevent the use of adequate doses of medication. ET pa­tients then are candidates for surgical or radiosur­gical treatment.

The mainstay of the surgical treatment of ET is deep brain stimulation (DBS), in which an electrode is implanted in the ventral inter­mediate nucleus (VIM) of the thalamus. Neurosurgeons Peter Nora, M.D., and Ryder Gwinn, M.D., have been implant­ing DBS electrodes at Swedish Medical Center for several years. The treatment is effective, but it requires implantation of permanent hardware (wires and batteries) into the brain and chest wall. Patients who take anticoagulants or have severe cardio­vascular disease are not suitable candidates for DBS. These patients, however, may be candidates for radiosurgical treatment.

A new option for difficult-to-treat patients

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