In general, SRS is useful for well-circumscribed lesions less than approximately 3 cm in diameter. For larger lesions, the radiation dose must be reduced because of anatomic and radiobiological constraints.
Published uses of SRS include:
● vascular lesions
○ Intracranial arteriovenous malformations (AVMs)(including dural arteriovenous fistulas)
○ cavernous malformations
● tumors
○ metastases:
see Stereotactic radiosurgery for brain metastases
see Stereotactic radiosurgery for Brainstem metastases
○ vestibular schwannomas
○ see Stereotactic Radiosurgery for intracranial meningioma
○ pituitary neuroendocrine tumors
○ glioma stereotactic radiosurgery
○ others: craniopharyngioma, pineal tumors, etc.
● functional disorders
○ trigeminal neuralgia
○ intractable chronic pain: thalamotomy
○ movement disorders: pallidotomy for Parkinson’s disease or thalamotomy for tremor (usually not a technique of choice because of the inability to perform physiologic stimulation before lesioning. Maybe a consideration for the rare patients who cannot undergo placement of a stimulator/lesioning needle)
○ psychiatric diseases (e.g. obsessive-compulsive disorder )
○ epilepsy