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Following the IV sedation, and after local injection of anesthetic agents (half Marcaine, half Xylocaine), the stereotactic head frame is applied to the head using titanium pins that attach to the outer table of the skull. This device provides great stability and reliability. The frame is anchored to the head by the neurosurgeon with the nurse assisting. The patient’s vital signs are carefully monitored during the frame application. The patient’s comfort level is assessed and if additional sedation is required, the nurse will administer the additional medication as ordered by the surgeon. The nurse next escorts and monitors the patient as they undergo brain imaging with the frame attached. All patients have one or more imaging studies that include MRI (if no contraindications to this imaging from pacemakers or other implants), CT, or angiography. Following the completion of the imaging phase, the patient returns to the Gamma Knife suite. At this time, patients may sleep, read, watch TV, or listen to music. The radiosurgical team – consisting of a neurosurgeon, radiation oncologist, and a medical physicist – will now start the computer planning. Once the patient’s individualized plan is finalized, the patient is ready to move into the Gamma Knife treatment vault. It is wise to have the patient use the rest room prior to the start of the treatment. Treatment times can vary from as brief as 15 min to as long as 2 h. Additional IV sedation may be used at this time. The patient is monitored by remote TV monitors by the nurse throughout the actual time of the radiation administration. The nurse will also be able to talk with the patient during the treatment through a built in microphone. If at any time a patient needs to take a break the treatment may be paused and the nurse can go in and check on the patient. The nurse will also stay in contact with the patient’s family so they are kept abreast of the patient’s progress.