Gamma Knife Surgery For Malignant Glioma

What you should know

  • Gamma knife surgery for malignant (mah-LIG-nant) glioma (gli-O-mah) is done to remove and treat a tumor (lump) in the brain. The brain is made up of neurons, which transmit and receive nerve signals, and glial cells, which support and nourish neurons. A malignant glioma forms when glial cells become cancerous. The glial cancer cells grow and divide without control or order. These cancer cells often make too much tissue and affect other nearby structures in the brain.

  • A head frame, special helmet and computer are used during surgery. Stereotaxy shows three-dimensional pictures of your brain on a TV monitor. Beams of radiation will be targeted through the many holes in the helmet. These beams pass through your skull and brain until they meet at the tumor. You and your caregiver will decide if this type of surgery for your malignant glioma is right for you. With gamma knife surgery, your malignant glioma may disappear. Your signs and symptoms caused by the glioma will also go away.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.


  • Problems may happen during surgery that may make open brain surgery necessary. Your brain, eyes, other bones and organs, blood vessels, or nerves may get injured while having the surgery. This radiation may cause nausea (upset stomach), vomiting (throwing up), skin or blood problems, or seizures (convulsions). Even after having surgery, there is a chance that your tumor may come back or not be completely removed.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Without treatment, a malignant glioma may grow and push other structures near it. If this happens, there is a danger that the blood or nerve supply to the other structures will be cut off. If this happens, you may have problems seeing, moving, speaking, breathing, or thinking clearly. This may lead to other serious medical problems, such as blindness, seizure (convulsion), or stroke. Ask your caregiver if you are worried or have questions about your surgery, medicine, or care.

Getting Ready

The week before your surgery:

  • Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.

  • Ask your caregiver if you need to stop using any of your present medicine. These may include aspirin, ibuprofen, or blood thinners.

  • Ask your caregiver before using any over-the-counter or herbal medicine or supplement. Tell your caregiver if you are already using these.

  • You may need to have a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan. You may also need other tests, such as chest x-ray, electrocardiogram (ECG), and blood tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

  • You may need to stop driving, lifting heavy things, or doing strenuous or tiring activities. Ask your caregiver how long you need to wait before starting your usual activities.

  • Your caregiver may give you steroids and other medicines to use. These medicines may help prevent seizures (convulsions) or stomach ulcers (sores).

The night before your surgery:

  • Ask caregivers about directions for eating and drinking.

  • You may be given a pill to help you sleep.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.

  • Do not wear contact lenses on the day of your surgery. You may wear glasses. Wear socks to help you stay warm.

  • What to bring: You may want to bring items such as a toothbrush and bathrobe.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine. .

  • An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy during your surgery.

  • You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the surgery. It also explains the problems that may happen, and your treatment choices. Be sure all your questions have been answered before you sign this form.


What will happen:

You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the radiation room and then moved into a special bed or couch. Caregivers may inject local anesthesia (numbing medicine) where the head frame will be placed. The head frame is attached to a helmet and computer. When your surgery starts, the special bed or couch you are lying on will be moved inside the treatment hood. Your caregiver may use stereotaxy to target beams of radiation into the holes of the helmet. These beams will pass through the skull and brain until they reach the target tumor. After treatment, your bed will be moved out of the hood. The head frame and helmet will be removed.

After your surgery:

You may be taken to a recovery room where caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. Caregivers will take you back to your hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have a fever.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • You have a sudden severe headache.

  • You have trouble seeing, breathing, speaking, or thinking clearly.

  • You passed out or had a seizure (convulsion).

  • Your face is getting numb or you cannot move your arms or legs.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.