Stereotactic intracranial radiotherapy/radiosurgery has come of age.

Abstract

The current, highly sophisticated, brain imaging techniques and three dimensional (stereotactic) mapping of intracranial targets, combined with recent developments in concentration of radiation therapy (x- or gamma-ray) onto these targets, have allowed obliterative treatment for many intracranial diseases previously the preserve of the neurosurgeon alone. Vascular malformations, acoustic neuroma, complex meningioma, pituitary adenoma and craniopharyngioma all fall into this category, as well as base of skull tumours. There are occasional indications for single (a few) cerebral metastases and possibly a highly selected role in primary malignant brain tumours. The subject of so-called 'radiosurgery' is an important and developing one and is complementary to modern neurosurgery.