Functional Radiosurgery

Overview

During the last 10 years interest in functional radiosurgery increased markedly. Cumulativenumbers of patients with functional diseases treated, using Leksell gamma knife, increasedfrom 2 to 10%. Two-thirds of this increase are accounted for by neuralgia of the trigeminalnerve. The spectrum of indications of functional radiosurgery can be divided into five groups:treatment of pain, extrapyramidal motor disorders, epilepsy, psychosurgery and ophthalmological indications. Because radiosurgery is by definition a non-invasive therapeutic method it isnot possible to verify the objective of stereotactic operations by stimulation. Therefore functionalradiosurgery develops markedly in indications where the objective of surgery is unequivocallydefined by visualization using magnetic resonance, i.e. treatment of pain. Radiosurgery bymeans of a gamma knife is gradually gaining an important position in the treatment ofneuralgia of the trigeminal nerve. The possibility of radiosurgical hypophysectomy in painfulosseous metastases is not appreciated sufficiently so far. In motor disorders radiosurgicaltreatment is a supplementary method as there verification of the objective of surgery bystimulation is most expressed. In psychosurgery the role of radiosurgery ensues from thegeneral position of this branch which is inhibited. In epileptosurgery radiosurgery is so far inthe stage of a clinical experiment. In ophthalomology a new perspective is investigated, i.e.application of radiosurgery in glaucoma resistant to other methods.

Key words:
pain - epilepsy - glaucoma - neuralgia of the trigeminal nerve - Parkinson’s disease- psychosurgery - radiosurgery - tremor.