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Nursing management of radiosurgery patients begins on the day they select radiosurgery as their management option in the clinic. During their clinic visit, the patient also meets with a dedicated Gamma Knife nurse who completes a nursing assessment and a screening brain imaging. The nurse provides the patient and family members with a preprinted list of procedure day instructions. The instructions include a phone number so the patient can reach the nurse directly for questions that may arise after they leave their initial appointment. When the patient arrives for radiosurgery, every effort is made to assign the nurse who saw the patient preoperatively. Patients are prepared for frame placement or mask preparation which begins at 06:30. Patients receiving IV conscious sedation are placed in a sitting position on a stretcher and the frame is placed by the neurosurgical team. The patient is monitored closely following IV sedation. The nurse accompanies the patient to imaging suits and takes care of their needs during the time they wait for dose plan finalization. Following the completion of the Gamma Knife procedure, the nurse assists in the removal of the stereotactic head frame and applies a dressing to the pin sites. Frame-based patients are usually discharged 1–2 h after the procedure. Mask-based patients are discharged after discussions with the physician. Patients are provided with preprinted discharge instructions that include what to expect following the Gamma Knife procedure. The instructions include how to care for the pin sites and whom to call in case of any problems.

© 2019 S. Karger AG, Basel

Gamma Knife radiosurgery is a minimally invasive management option for a variety of brain disorders. The indications include acoustic neuromas, meningiomas, arteriovenous malformations, pituitary tumors, gliomas, metastatic brain tumors, and other malignant brain tumors. Carefully selected patients with essential tremor or parkinsonian tremor, trigeminal neuralgia, or severe obsessive compulsive/anxiety disorders have benefited from Gamma Knife surgery. Gamma Knife treatment is provided in four stages:

Stage 1 – preoperative evaluation,

Stage 2 – intraoperative care,

Stage 3 – postoperative care management, and

Stage 4 – discharge and follow-up counseling.

At the Center for Image-Guided Surgery in Pittsburgh, our goal is to optimize the Gamma Knife patient experience by providing continuity of care for each of these stages. Our experience over the last 30 years now approaches 15,000 patients. At our center, we currently have two Gamma Knife units, The LGK Perfexion, used for frame-based procedures, and the most recent version, the LGK ICON, used for frame-based and mask-based procedures. Since we brought the first clinical Gamma Knife to the USA in 1987, we have used the models U, B, C, 4C, Perfexion, and ICON. Patient preparation and nursing management is essential in optimizing the Gamma Knife patient care experience.