Culture Spotlight

This medical procedure lands a clean headshot at brain abnormalities

Stereotactic radiosurgery doesn’t need to split your head open to treat brain tumors and splitting headaches.
Partner Feature | May 31 2019

Around two years ago, Irish lost consciousness after complaining about an intense headache. Her family wasted no time rushing her to the nearest hospital for immediate treatment.

Initial CT scans revealed profuse bleeding inside her brain. Leo, Irish’s father, transferred her to The Medical City (TMC), where she was confined at the intensive care unit. A critical care pediatrician and a neurosurgeon took care of the 13-year old, running tests to further probe into the young girl’s condition. 

Imaging results showed that there was more than just bleeding in Irish’s brain -- excess fluid accumulation and pressure was also increasing. Furthermore, they discovered that her brain hemorrhage resulted from ruptured abnormal vessels. Known as arteriovenous malformations (AVM), this tangle of poorly-formed arteries and veins may occur anywhere in the body, but they are especially dangerous when present inside the head. Bleeding that occurs from the AVM may injure parts of the brain, inducing stroke-like states, permanent disabilities, or even death.

For a young girl like Irish, conventional, invasive surgery may prove too dangerous to remove an AVM. Dr. Louie Racelis, the neurosurgeon in charge, thought of subjecting the patient to stereotactic radiosurgery (SRS), but only after conducting more thorough observations and tests.

 

Understanding stereotactic radiosurgery

“SRS is a form of radiation treatment that uses a  focused beam of radiation at a much higher dose, done in only a single or few treatments as compared to traditional radiation therapy,” says Dr. Racelis. "With SRS, we can reach tumors and abnormal blood vessels like AVMs in the brain without the risk of surgery.”

Functioning exactly like other forms of radiation therapy, SRS impairs tumor cells and prevents them from reproducing further and for blood vessel disorders like AVMs, cause the blood vessels to 'close up'. It can also treat multiple kinds of tumors, whether they may be benign or malignant.

In the case of treating AVMs, SRS induces changes in the walls of the affected blood vessels, closing them off and blocking blood flow. In this way,  chances of internal bleeding from the AVM are reduced to zero. These changes take place gradually and may take two to three years to occur.

Dr. Racelis notes that patients can experience faster recovery time with SRS. It can also be an option for those who have received previous radiation therapy, as the focused X-rays can avoid previously treated areas. They also don’t need to worry about incisions, as the procedure requires no incision to be made.

“We understand that there can be slight discomfort with the metal head frame affixed to the skull during usual radiosurgery procedures. So, at TMC, we offer a more patient-friendly option.” Dr. Racelis is talking about a comfortable patient-tailored removable mask that they use during treatment, delivering high doses of radiation accurately without clamping the patient’s head to the treatment table with a metal frame.

 

Irish’s road to recovery

Six months after Irish was admitted to the hospital, Dr. Racelis performed SRS at the Radiation Oncology Department of TMC. The procedure lasted for 45 minutes, and Irish was allowed to go home after her treatment.

While she experienced nausea and vomiting immediately upon arriving home -- side effects that may usually happen SRS -- Irish has been spared from her splitting headaches. Now able to focus well, she was able to go back to school and resume her studies. For the next two to three years, she was advised to have regular check-ups and scans every six months to assess her health and progress.
 

Stereotactic Radiosurgery at TMC

The Medical City takes pride in their advanced radiation therapy system for SRS. Called the TrueBeam Linear Accelerator, this innovation is also used for other procedures that deliver radiation to tumors in the body. With this, clinicians can provide more tailored treatments for their patients’ specific clinical circumstances. For more information about Stereotactic Radiosurgery (SRS), please contact the Radiation Oncology Department of The Medical City at 9881000 ext. 6101 or 6102.