Changing times and early debates.

The machine was soon being called the Gamma Knife. Its spread led to increasing numbers of papers from different centers but particularly Pittsburgh. As mentioned in the preface, the introduction of new methods in medicine is seldom without problems. There were a number of squabbles about the treatment of various indications. It was suggested that for AVMs, the GKS was unnecessary. For meningiomas, there was marked skepticism within the milieu itself in the early days. Metastases were not treated in Stockholm because of Leksell's opposition to the treatment of malignant disease, and indeed, these tumors became generally popular indications rather later. There was a thought that pituitary adenomas could be better treated with GKS but it proved too unreliable, and for these tumors, GKS remains an ancillary treatment method. The most marked disagreements were with respect of the vestibular schwannomas. This discussion continues to the present.