Stereotactic Radiosurgery (SRS) [Neurosurgery Wiki]

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===== Stereotactic Radiosurgery (SRS) =====

**Stereotactic radiosurgery (SRS)** is a non-invasive therapeutic procedure that delivers **high-dose ionizing radiation** to a precisely defined intracranial target with **sub-millimeter accuracy**, typically in **one to five fractions**.

Unlike conventional radiotherapy, SRS relies on:
  * **Stereotactic localization systems** (frame-based or frameless)  
  * **Advanced imaging techniques** (CT, MRI, PET)  
  * **Steep dose gradients** to spare surrounding healthy tissue

SRS is most commonly used for:
  * **[[Brain metastases]]**
  * **Arteriovenous malformations (AVMs)**
  * **Vestibular schwannomas**
  * **Meningiomas**
  * **Functional disorders** (e.g., trigeminal neuralgia)

Despite the term "surgery," no incision is made. The "surgical" aspect refers to the **precision and therapeutic intent**, akin to resection.

==== Key Concepts ====
  * **Single-session (classic SRS)** vs. **Hypofractionated stereotactic radiotherapy (HSRT)**
  * Delivered using systems such as **Gamma Knife**, **CyberKnife**, or **LINAC-based platforms**

> **Clinical goal**: Maximize tumor control or lesion ablation while minimizing damage to adjacent critical structures.