Gamma Knife® Not Just for Adults

By Rashel Stephenson

Nicholas’ Life-Changing Headache

After 20 years at Piedmont Hospital, non-invasive Gamma Knife® stereotactic radiosurgey specialists have treated nearly 2,300 patients, including children. The following stories profile two children who benefitted from the Gamma Knife after experiencing arteriovenous malformations, or AVMs.

Vicki Clemens knows what it’s like to have to redirect the energy of a young child. Her son Nicholas had an AVM rupture when he was just eight years old. He was playing video games with his two older brothers when he flew out of the room screaming of a headache.

“I knew from his tone that something was really, really wrong,” Clemens recalls. She gave him Tylenol, but his symptoms continued. He began throwing up, started to become incoherent, and eventually, he couldn’t move his body.

The Clemens drove to the nearest hospital, but Nicholas was immediately life-flighted to Scottish Rite. “That was the decision that saved Nicholas’ life,” says Clemens. “Dr. Reisner was at the hospital within minutes and knew how to treat Nicholas.”

Andrew Reisner, M.D., pediatric neurosurgeon, immediately put a shunt into Nicholas’ brain to release the build-up of fluid because too much pressure, or pressure that was present too long, would have damaged his brain tissue.

Nicholas was in the children’s hospital for 17 days and then was ready for Gamma Knife® surgery at Piedmont Hospital. “Piedmont is an adult hospital,” says Clemens, “but it was amazing how well they were able to adapt to treating Nicholas.” Clemens was especially amazed at how engaged the entire staff was with the family. “They updated us on every move they made and educated us about everything that was taking place. We were so grateful for that.”

After the Gamma Knife procedure, Nicholas returned home knowing he would have to take precautions to protect his head while the radiation slowly healed the vessels inside. He sacrificed his position as catcher for his baseball team; he stopped playing street hockey and basketball; and perhaps most difficult, he tamed the general rough-housing with his brothers.

“For the first two years, we went back every few months for CT scans or MRIs,” says Clemens. “Each time, we saw the AVM growing smaller and smaller. Now there’s nothing left.”

Eleven-year-old Nicholas discovered a new passion during his recovery – this smart, straight-A student has taken a particular interest in working his way to becoming a neurosurgeon.

AVM Symptoms and Treatment

AVM Symptoms and Treatment Brain arteriovenous malformations, or AVMs, are congenital and often cause no signs or symptoms until they rupture, resulting in a brain hemorrhage. If symptoms do occur, they are most likely developed before age 50 and can include stroke-like symptoms, mild or disabling headache, seizures or pulsating noises in the head. Bleeding is the most serious complication of an AVM and is the main reason for treatment.

AVMs can be treated in three ways: embolization, surgery or stereotactic radiosurgery, like the Gamma Knife. The Gamma Knife procedure is surgery using radiation as a scalpel, so it’s non-invasive. Perhaps most importantly, the Gamma Knife is extremely targeted and precise, using directed radiation to treat AVMs while sparing damage to the surrounding structures and tissues of the developing brain. The benefits include low risks of infection or anesthesia reactions, virtually no pain and quick return to normal activities.

Gamma Knife surgery is playing a larger role than ever in the management of children and adults with many types of brain disorders. With further experience, it is likely the indications for Gamma Knife surgery in the management of these disorders will continue to expand.

Piedmont remains the regional leader in Gamma Knife radiosurgery. The first in the Southeast and fourth in the nation to host the Gamma Knife, Piedmont has more than 20 years of experience with this revolutionary technology. For more information on Piedmont’s Gamma Knife Services, call 404-605-1935 or visit piedmonthospital.org.