Stereotactic radiosurgery using the 201 cobalt-60 source gamma knife.

Although Lars Leksell introduced the concept of stereotactic radiosurgery 40 years ago, the role of radiosurgery in the treatment of vascular malformations and benign or malignant intracranial tumors is only now being defined. Radiosurgery can be definitive therapy for small or medium-sized arteriovenous malformations and histologically benign tumors. For patients with more complex or recurrent tumors and for patients with vascular malformations that have not been eliminated by open surgery or endovascular embolization, radiosurgery has an adjunctive and often decisive therapeutic role. Selected malignant tumors, especially solitary metastases, have responded dramatically to radiosurgery, obviating the need for craniotomy and prolonged hospitalization in this group of patients.