[Stereotactic radiosurgery nursing care].

Stereotactic radiosurgery (SRS) is a minimally invasive and safe surgical approach. An increasing number of individuals conform to SRS indications and select SRS as a substitute for traditional intracranial surgery. However, SRS still has deficiencies and side effects. Therefore, nurses must understand the mechanisms and side effects of SRS in order to provide appropriate clinical nursing intervention to reduce pre-treatment anxiety, understand SRS procedures and appreciate potential side effects. Such can be expected to improve patient quality of life during hospitalization and after discharge.

Quality of life: Gamma Knife surgery and whole brain radiation therapy.

Cerebral metastasis of cancers originating outside the brain has traditionally been treated with whole brain radiation therapy (WBRT). Gamma Knife Radiosurgery (GKS) provides safe and effective alternative treatment that is less invasive and has fewer side effects. Both WBRT and GKS are reviewed and discussed in terms of quality of life and health outcomes. The case studies of two individuals who underwent Gamma Knife surgery are presented.

Frameless, image-guided stereotactic radiosurgery.

OBJECTIVES: To trace the evolution from frame-based to frameless image-guided SRS, to discuss the basic radiobiological principle of fractionation, current clinical trial data, and procedural components of the treatment plan. DATA SOURCES: Nursing and medical literature, neurosurgical textbooks, and select internet sites. CONCLUSION: The CyberKnife (Accuray, Sunnyvale, CA) is the newest machine added to the technologic armamentarium of patient care. Its capacities are only beginning to be explored and the possibilities are limitless, giving hope to countless persons. IMPLICATIONS FOR NURSING PRACTICE: Technologic advances have necessitated a diversification of nursing roles. Coordination of patient care services requires nurses to advance their knowledge of frameless, image-guided SRS.

Stereotactic radiosurgery for brain lesions: an observation and follow-up.

Stereotactic radiosurgery (SRS) is a technique for obliterating intracranial targets that are inaccessible or unsuitable for open surgical techniques. By means of well-collimated beams of ionizing radiation, a high-dose, single fraction of radiation is delivered to a defined volume of tissue. The entrance and exit doses are distributed in such a way that tissue outside the target is minimally affected. Treatment effects are seen on scans or angiograms after several months or a few years; consequently, follow-up scans are necessary. The first 72 patients who underwent SRS at the Department of Neurological Sciences and Radiation Therapy, Christian Medical College and Hospital were followed. Of the 72 treated, 35 had arteriovenous malformations, while 37 had brain tumors. Of the 37 patients with brain tumors, 14 had meningioma and 17 had acoustic neuroma. Six patients had other lesions such as pineal tumor, hemangioblastoma, astrocytoma, or metastasis. Of 72 patients, 43 came for follow-up. Twenty-three of the followed-up patients showed improvement; 10 clinically and radiologically remained the same, and 2 died due to recurrence. Of 43 patients, 3 continue to have cranial nerve deficit. Four patients were later found to have central necrosis and clinical deterioration. Observation of outcomes following SRS helps neuroscience nurses identify home healthcare strategies such as chest care, eye care, facial massage, and exercises along with the other specific nursing care. Although nursing care has become more technically oriented, the patient's physical, educational, spiritual, and emotional needs must be addressed.

Gamma knife radiosurgery: a patient-friendly procedure.

Gamma Knife surgery (GKS) is a minimally invasive neurosurgical procedure used to treat a variety of cranial lesions and disorders. Gamma Knife surgery technology and conditions treated are discussed in this paper. The patient experiences during the treatment phases are also reviewed. The incision-free technology was introduced by Lars Leksell and Bjorn Larson in 1967 in Europe, and has been available in the United States since 1987 (Ganz, 1997). Gamma Knife surgery has expanded internationally with over 170 sites worldwide treating over 250,000 patients using focused beams of Cobalt-60 radiation. Winnipeg's Health Sciences Centre opened the first Canadian Gamma Knife centre in November 2003.

Understanding stereotactic radiosurgery for intracranial tumors, seed implants for prostate cancer, and intravascular brachytherapy for cardiac restenosis.

Our 21st century has moved us into a world of technology never imagined. The aim of our article is to move oncology nurses beyond the realm of external beam radiation therapy. We chose to present 3 modalities of high precision that are infiltrating the everyday world of radiation therapy. Stereotactic radiosurgery for intracranial brain tumors and brachytherapy for prostate cancer require an expanded knowledge base for nursing to deliver excellent patient care. Cardiac patients receiving radiation seeds is new in the world of oncology nursing. These patients are unique but they are now a part of our world. Expanding our knowledge base to include a radiation procedure in cardiac care does bring us beyond the world of external beam radiation. Patients often seek information from nurses. Having an understanding of the basic principles and techniques will enable oncology nurses to educate patients. The purpose of this article is to explain the procedure of stereotactic radiosurgery, brachytherapy for prostate cancer, and intravascular brachytherapy for cardiac restenosis. Our discussion will include selection criteria, potential sides effects and risks, and nursing care.

Steriotactic posteroventral pallidotomy.

The use of the stereotactic posterovental pallidotomy is a surgical option increasingly considered for the treatment of Parkinson's Disease. This treatment method requires a multidisciplinary team. The clinical nurse specialist is in the best position to coordinate this multidisciplinary effort to provide successful total patient care.

The viewing wand--its introduction and uses.

The Innovated Systems Group (ISG) Viewing Wand was developed in Toronto, Canada, for use in Neurosurgery. In June 1992, Frenchay Hospital was the first centre in Europe to pioneer the use of the ISG Viewing Wand, which is an intraoperative image display system. This equipment has in the main replaced stereotaxic surgery by removing the need for a cumbersome frame and intra-operative scanning. However, there is still a need for stereotaxic surgery for point source localisation of small deep seated targets e.g. thalamotomy and pallidotomy. The aim of this article is to explain what the Viewing Wand is, what it does and the effect this hi-tech equipment has had on theatre nursing practice.

Stereotactic radiosurgery: new practice frontiers for the perioperative nurse.

Stereotactic radiosurgery (SR) is a technology that blends the skill and technology of several disciplines such as neurosurgery, radiation oncology, radiology, engineering, medical physics, and nursing. The improvement of neurological imaging that occurred in the 1970s and 1980s provided diagnosticians with the technical foundation necessary to support parallel advancement of SR. Today, SR is used to treat pituitary tumors, meningiomas, acoustic neuromas, arteriovenous malformations, metastatic tumors of the brain, craniopharyngiomas, and residual gliomas. Participation in SR procedures provides the perioperative nurse with an opportunity to move beyond the walls of the operating suite into the exciting world of neurological imaging and radiotherapy.