Summary:
During the last 10 years interest in functional radiosurgery increased markedly. Cumulative
numbers of patients with functional diseases treated, using Leksell gamma knife, increased
from 2 to 10%. Two-thirds of this increase are accounted for by neuralgia of the trigeminal
nerve. The spectrum of indications of functional radiosurgery can be divided into five groups:
treatment of pain, extrapyramidal motor disorders, epilepsy, psychosurgery and ophthalmological indications. Because radiosurgery is by definition a non-invasive therapeutic method it is
not possible to verify the objective of stereotactic operations by stimulation. Therefore functional
radiosurgery develops markedly in indications where the objective of surgery is unequivocally
defined by visualization using magnetic resonance, i.e. treatment of pain. Radiosurgery by
means of a gamma knife is gradually gaining an important position in the treatment of
neuralgia of the trigeminal nerve. The possibility of radiosurgical hypophysectomy in painful
osseous metastases is not appreciated sufficiently so far. In motor disorders radiosurgical
treatment is a supplementary method as there verification of the objective of surgery by
stimulation is most expressed. In psychosurgery the role of radiosurgery ensues from the
general position of this branch which is inhibited. In epileptosurgery radiosurgery is so far in
the stage of a clinical experiment. In ophthalomology a new perspective is investigated, i.e.
application of radiosurgery in glaucoma resistant to other methods.
Key words:
pain - epilepsy - glaucoma - neuralgia of the trigeminal nerve - Parkinson’s disease
- psychosurgery - radiosurgery - tremor.
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