1- Registration

You will be required to get all available investigations which should include at least a recent Brain MRI with contrast.

The available investigations will be reviewed and if any other investigation was required, you will be asked to prepare it.

2- Out patient clinic appointment

You will have an appointment with the medical director of the center professor doctor Wael A. Halim to evaluate the case and discuss choices of treatment with you.

Both registration and Outpatient clinic services are free of charge.

3- You will get a medical report and administrative letter of the fees - upon request- to cover financial issues according to the center pricing policy.

4- You will get an appointment regarding treatment date

5-Treatment day

In general the treatment takes one day out of the patient’s life which is carried out as an outpatient procedure during that day.

The patient arrives at 08:30 AM o’clock and should fast from midnight unless they are diabetic. Diabetic patients should not change their diet or fast. The patient

will arrive at the Center with those members of the family who are deemed suitable to assist and support. On arrival the patient will be asked to sign off the treatment consent,

Then he will be prepared by the nurse for treatment, gown wearing, I.V canula application. Final assessment and frame application takes place in the frame application room.

The findings from this brief appraisal form the clinical base-line, which will be used to assess progress in the months and years to follow.

The frame:

This is a metal ‘crown’ which is fixed to the head with four pins, which are screwed to the bone. The frame is made of aluminium and is quite light and is not uncomfortable to wear. However, the application does require 4 injections of local anaesthetic, two to the forehead and two to the back of the head. These sting a little. If a little

time is taken the actual screwing in of the pin is painless. However, the frame has to be applied tightly and some pressure is felt. Patients react very differently

to this. However, all seem to agree that the feeling of pressure becomes tolerable after 5 to 10 minutes.

Once the frame is applied the next stage is to take the images. These are usually MRI images today. It is necessary to check the accuracy of the MRI

machine with each examination. The patient is placed in the MRI and the images are taken after an injection of MRI contrast material (gadolinium).

The MRI is painless though for some patients the position in which they lie can be a bit awkward. The procedure seldom takes more than 15 to 20 minutes.

After the MRI is over the patient must settle down to a long wait. The doctors will be introducing the images into the computers and then start planning

the treatment. This can take a few minutes but it is not unusual for planning to take an hour or two.

The patient is welcome to have drinks during this period.

When the treatment planning is finally completed the patient will be taken to the Gamma Knife room and attached o the Gamma Knife.

He/She will then be drawn in and out of the machine several times. This can take time and is not a very interesting experience.

In fact after the images are taken the patients have a fairly boring day. Once the treatment is complete the frame is removed and the head is bandaged

overnight, in case there is any oozing of blood from the places where the pins pierced the skin. The treatment is now over and the patient may return home.

6- Follow up :The next follow up will be at 3 to 6 months depending on the nature of the disease. Most follow up is with MRI as a basic requirement, other investigation may be required.

7- There is one variation to the routine described above and that is in the case of children who may well require a general anaesthetic.

The following short tale is the best way to illustrate how easy it is to tolerate Gamma Knife Radiosurgery, which is a true out-patient procedure for adults.

“There was a man treated in Stockholm in the morning and in the afternoon he chaired the board of his company”.

The picture shown here is from a patient treated in Cairo in fact the first patient treated at the Gamma Knife Center Cairo. She has graciously allowed

us to use this picture.

As the reader can see, she is coping with her treatment day without any major problem.