Diverse Clinical Aspects

Abstract

This chapter is concerned with sundry factors related to patient assessment and Gamma Knife surgery, but unrelated to a specific diagnosis. There is a widely accepted assumption that the radiosensitivity of cerebral tissue, in different locations within the brain varies. The truth of this assumption and how it should affect doseplanning is clearly important. Moreover, a number of the lesions treated in the Gamma Knife are located at the base of the skull, close to a variety of important extracerebral structures. The tolerances of these structures are also a source of concern for the user of the Gamma Knife. Then, it is important to consider the influence of the volume of the lesion on the results of treatment on the lesion itself and on the tissue around. Another area which may give rise to confusion is the effect of the Gamma Knife on symptoms. It is a commonplace that a patient seeks a doctor to obtain relief of a symptom or symptoms but is treated for a disease: while the symptoms may or may not be alleviated. This discrepancy between the patient’s wishes and the patient’s best interest is also relevant for those who require Gamma Knife surgery.