Every year, about 80,000 people are treated by neurosurgeons with a tool called the Leksell Gamma Knife®, which treats small and medium-sized brain tumors.

Understanding Gamma Knife treatment, including how and when it is used, can help you determine if you may be a good candidate for this highly effective, non-invasive procedure.

Contrary to its name, the Leksell Gamma Knife® doesn’t involve a knife or blade, and the surgeon makes no incisions. The treatment is a type of radiation based on the concept of concentrating beams of radiation into a very small point. It was invented by a Swedish neurosurgeon, Professor Lars Leksell, in 1967, and is also called radiosurgery or stereotactic radiosurgery.

The Gamma Knife functions similarly to a magnifying glass that, when held up in the sun, concentrates the sun’s rays into a tiny, powerful beam. The Knife is used to deliver focused radiation to small areas of the brain in a very exact way.

Gamma Knife treatment can be used for:

• Small to medium-sized brain tumors that arise from the brain itself
• Malignant (cancerous) brain tumors that have spread from other parts of the body such as the breast, lung or kidney
• Small blood vessel abnormalities such as arterio-venous malformations.

Benefits of Gamma Knife Treatment

If the Gamma Knife is like a magnifying glass, conventional radiation treatment is like being at the beach — when you get a sunburn, you get it over your whole body. And when conventional radiation is used to treat brain lesions, it also irradiates (and damages) otherwise healthy brain tissue surrounding the lesion.

Because Gamma Knife treatment uses highly focused radiation to very exact points of the brain, it minimizes damage to the brain while maximizing the positive outcomes for the patient.

What Does Gamma Knife Treatment Involve?

Gamma Knife treatment is a painless, outpatient procedure that only needs to be performed once. On average, the procedure takes around two hours.

Patients remain awake throughout the procedure and are generally able to go home and return to normal activities a few hours after treatment. Within a few months, tumors may begin to shrink. In many cases, the tumor shrivels down and disappears.

Are You Eligible for Gamma Knife Treatment?

Many brain abnormalities that can be treated with conventional radiation may also be treatable with Gamma Knife radiation, if they are small enough.

For example, a woman with a brain tumor that came from her breast could be an excellent candidate for Gamma Knife treatment, provided the tumor is less than one inch in diameter. After using an MRI to pinpoint the tumor’s location, a neurosurgeon trained to use the Gamma Knife would work with a radiation oncologist to devise a treatment plan.

Working together, the neurosurgeon and radiation oncologist would perform the Gamma Knife treatment to eventually eliminate the tumor.

If you or a loved one are dealing with a small brain tumor or other abnormality, consider reaching out to a Gamma Knife specialist who can help you determine if this noninvasive, highly effective treatment is an option for you.

If you or a loved one is seeking treatment for a brain tumor, are interested in Gamma Knife radiosurgery, or to schedule an appointment with Dr. Diaz or any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

Migraines affect more than 10 percent of the world’s population, and migraine disease is considered to be one of the main causes of disability worldwide.

One study of people with migraine disease in the United States found that over half were unable to engage in day-to-day activities, including work or school, because of migraines.

Women are hit especially hard by migraines; migraine disease is 3 times more common in women than men, affecting around 1 in 5 American women.

Understanding migraines including how they're different from other headaches and what can trigger them and why the triggers might change may help you manage them better.

Symptoms, Phases Set Migraines Apart

Migraine is produced by chemical activity in the brain, nerves and blood vessels surrounding the skull and muscles of the head and neck.

Migraine is different from other headaches because it comes as a cluster of symptoms, and usually occurs with the same triggers and symptoms every time, though triggers can change over time, especially with hormonal changes.

Classic migraine is also unique in that it typically occurs in four phases.

During prodrome (pre-migraine) phase, you might experience:

• Sensitivity to light, sound and smells
• Mood changes
• Pain and/or stiffness in the neck
• Yawning
• Food cravings
• Constipation
• Diarrhea

Aura phase, which doesn’t happen for everyone, is usually characterized by visual and sensory changes such as:

• Seeing flashing lights and/or zigzag lines
• Blurred vision
• Tingling
• Numbness
• Slurred speech
• Difficulty thinking or writing clearly

Headache phase is characterized by:

• Intense pain on one or both sides of the head

Postdrome phase is the post headache phase when symptoms generally include:

• Exhaustion
• Confusion
• Feeling unwell

Although not everyone with migraine disease goes through all four phases, the symptoms and phases an individual experiences tend to be the same every time. Recognizing this pattern helps people know they’re having a migraine.

Common Migraine Triggers

While not all migraines are triggered, some people find that certain factors tend to kick off a migraine for them. Common migraine triggers include:

• Stress
• Sleep disturbances, including a change in sleeping patterns such as sleeping late on the weekends
• Hormone changes
• Foods that contain a compound called tyramine (including fermented foods, certain aged cheeses, red wine, smoked foods and cured meats)
• Changes in weather/humidity fluctuations
• Dehydration
• Altitude changes
• Strong smells such as perfume
• Medications

Another surprising (and surprisingly common) migraine trigger? Chewing gum. Up to 50 percent of people with migraine disease also have temporomandibular joint (TMJ) disorders, conditions affecting the jaw joints and surrounding muscles and ligaments that can be aggravated by gum chewing.

It’s a good idea to pay attention to your personal triggers; if you’re able to identify and avoid them when possible, you may be able to lessen the number of migraines you experience.

Why Triggers May Change Over Time

Some people — especially women — may find that their migraine triggers change as they get older, or that they experience fewer or more migraines at certain times (such as during pregnancy or menopause). This is because hormone levels fluctuate throughout a woman’s life, and hormone changes can trigger a migraine.

Other things that might cause triggers to vary over time include nutrient deficiency (such as low vitamin D levels) and thyroid problems. But you shouldn’t assume that these things are triggering your migraines without talking to a healthcare provider.

When to See a Doctor

If you notice a change in the pattern of your headaches — particularly if they become more frequent and you have them more than three times per week — it’s a good idea to talk to your doctor about an evaluation.

More concerning are headaches that occur during physical activity such as exercise or bending over, or if a headache is severe enough to wake you from sleep. If you’re awoken by a headache or suddenly develop a headache more painful than any you’ve had before, it’s an emergency and you should seek care immediately.

Other headache symptoms that necessitate emergency treatment:

• Neck stiffness with fever and/or rash
• Shortness of breath
• Dizziness
• Neurological symptoms such as loss of balance, slurred speech or paralysis on one side of your body
• Nausea and vomiting (if severe and you’ve never had it with a headache before)

In general, it’s better to be safe than sorry when it comes to headaches, so don’t hesitate to reach out to your doctor if you’re concerned.

If you or a loved one is seeking treatment for a condition of the brain, or to schedule an appointment with any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

Knowing the signs and symptoms of a stroke, and what to do when you spot them, may save someone’s life. The acronym, BEFAST, can help.

Catching Stroke Quickly Increases Chances of Survival

In the last three decades, medicine has made huge strides in stroke management — but the window of treatment is very narrow.

A stroke can get very bad, very quickly, meaning you have a limited amount of time to respond if you hope to have a good outcome.

In most cases, stroke can be treated with either medical or surgical therapy. But stroke remains the fifth leading cause of death and the number one cause of loss of independence, which is why it’s so important that people know the signs and act quickly.

Because of this, experts created the acronym BEFAST to help people remember and recognize the most common stroke symptoms.

• Balance problems, dizziness, and/or loss of coordination
• Eye trouble, including blurred vision and difficulty seeing out of one or both eyes
• Facial drooping or numbness on one side of the face
• Arm weakness or numbness on one side
• Speech difficulty, including stuttering and/or slurred speech
• Time to call 911 if a person shows any of these symptoms, even if they go away

Even with an acronym to remind you of stroke symptoms, you might not recognize the signs right away. It may be helpful to focus on the physical signs; if someone is unable to speak, has a facial droop or can’t move one side of their body, or if their hand flops down when you raise it, there’s a good chance that person is having a stroke.

The Importance of Comprehensive Stroke Treatment

Once you’ve identified signs of a stroke using BEFAST, it’s time to get help.

When you call 911, request that the person be taken to a comprehensive stroke center to ensure the most accurate diagnosis and best possible treatment.

The most crucial step when it comes to diagnosing a stroke is getting an image of the brain with a CT or CAT scan to determine the cause and type of stroke. Ideally, imaging will be followed by a more comprehensive evaluation using the stroke scale developed by the National Institutes of Health (NIH). This 42-point evaluation goes far beyond BEFAST, allowing healthcare providers to learn details about a stroke that help them determine how best to treat it.

Managing Expectations About Stroke Treatment and Recovery

How effectively a stroke can be treated, and how well a person recovers, depend largely on how early the stroke is diagnosed; the earlier the stroke is detected, the better the outcome is likely to be. When blood flow to the brain is blocked, which is what happens during a stroke, there’s going to be a certain amount of damage even after normal blood flow is restored.

This means stroke patients who have been successfully treated can still experience effects such as weakness on one side of the body or problems with speech, but often will recover to the point of independence. Recovery from a stroke usually takes between three and six months, but is highly dependent on the extent of the stroke.

Even better than catching a stroke early is not having one at all. Preventive measures such as maintaining a healthy weight and keeping blood pressure and cholesterol in check can go a long way in keeping your heart healthy and reducing your risk of stroke.

If you or a loved one is seeking treatment for a condition of the brain, or to schedule an appointment with Dr. Steele or any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.