Frequently Asked Questions

Radiation delivery is not felt. If a frame is used, local anesthesia may cause a brief sting and pressure. Mask-based treatment is not painful.

Hair does not need to be cut and hair loss is not expected. A small area of temporary hair loss can occur for targets very close to the scalp.

It is not necessary for the great majority of adults. Sedation or general anesthesia may be used for children or patients with particular clinical needs.

Radiation time depends on the number, size and location of the targets. In some situations, imaging and planning may make the total time at the hospital longer.

Yes, for appropriately selected patients. Position is verified with imaging at every session and head movement is continuously monitored throughout treatment.

Most treatments can be delivered in one session. For large targets or targets close to sensitive structures, the total dose can be divided over several days. This does not mean that the treatment is weaker.

No. Radiation does not remain in the body and you do not expose people around you to radiation.

Usually not. Tumor control, pain reduction or AVM closure may develop over weeks, months or years.

Not always. Especially for benign tumors, the main goal is often to stop growth and preserve neurological function rather than make the tumor disappear.

Headache, fatigue or sensitivity at frame contact points can occur early. Swelling, radiation-related tissue change or neurological effects specific to the treated area can occur later.

Most patients return to daily activities within one or two days. Seizures, balance or vision problems and the medications being used can affect the timing of driving and returning to work.

The effect of Gamma Knife develops over time. Regular examination and MRI, and when relevant hormonal, hearing, vision or angiographic assessment, are therefore important.

DBS usually does not eliminate the underlying condition. Its goal is to reduce the symptoms that affect daily life most and improve function.

In Parkinson’s disease, DBS does not stop disease progression. In essential tremor it aims to reduce tremor, in dystonia involuntary contractions, and in epilepsy seizure frequency.

Patient selection is one of the most important factors in treatment success. Diagnosis, duration of illness, response to medication, impact on daily life, brain MRI findings, general health and expectations from surgery are assessed together.

For Parkinson’s disease, detailed movement-disorder examination, comparison of periods with and without medication, neuropsychological assessment and brain imaging may be required. The decision is usually made by a team that includes neurology, neurosurgery, psychiatry or neuropsychology specialists.

Age alone is not an absolute barrier. Biological age, general health, heart and lung conditions, cognitive status, blood-thinning medication and expected benefit are considered together.

Some older patients may be suitable, while a younger patient may not be suitable because of other health problems.

The same method is not used for every patient. Surgery may be performed entirely under general anesthesia, or the patient may be awake for selected stages so that the effect of electrode placement can be assessed.

For awake surgery, the scalp is numbed with local anesthesia and sedative medication is used for comfort. The most appropriate method is discussed in detail before surgery.

The scalp and surgical areas are numbed with local anesthesia. During stages performed under general anesthesia, the patient does not feel anything.

Pain, tenderness or tightness in the head or chest can continue for a few days after surgery and is usually controlled with standard pain relief.

Usually not. Only small areas where incisions will be made are generally trimmed. Practice may vary according to the surgical method and the center’s infection-prevention protocol.

Duration varies according to one- or two-sided electrode placement, the surgical method, the condition being treated and whether the pulse generator is placed during the same or a separate procedure. Preparation, imaging and target verification are also included in the total time.

The length of stay depends on general health and the stages of surgery. In uncomplicated cases, one or two nights may be sufficient, although longer observation is used when needed.

Although the system may be checked during surgery, permanent programming usually begins during the recovery period. Timing depends on the condition, surgical method and the center’s protocol.

Tremor and some Parkinson’s disease symptoms may change quickly during programming. In dystonia, clinical benefit may take weeks or months to develop.

The best result may not be reached at the first programming session. Several visits may be needed to find the most appropriate settings.

Medication should not be stopped without medical advice. Doses can be reduced for some people with Parkinson’s disease, but complete discontinuation is not always the goal of DBS.

Medication for epilepsy, dystonia and obsessive-compulsive disorder also usually continues for a period. Changes are made gradually according to treatment response.

The pulse generator is usually placed under the skin a few centimeters below the collarbone. A slight prominence may be visible in thin patients. The lead connecting the electrodes to the generator runs under the skin of the neck and can sometimes be felt.

Rechargeable and non-rechargeable options are available. Battery life depends on the device model, the intensity of stimulation and daily energy use.

Non-rechargeable batteries generally last several years. Rechargeable systems can be used for longer but need to be charged by the patient at regular intervals. When the battery is depleted, the brain electrodes usually remain in place and only the chest pulse generator is replaced in a shorter operation.

A patient controller may be provided to check the battery level and make limited changes within boundaries approved by the clinician. Patients should not make broad program changes on their own; treatment settings should be adjusted by the specialist team.

As with any brain surgery, risks include infection, bleeding within the brain, seizures, wound-healing problems, mechanical problems involving the electrodes or connecting leads, and anesthesia-related complications.

Stimulation may cause speech difficulty, imbalance, tingling, muscle contractions, double vision or involuntary movements. Many of these effects can be reduced by changing the device settings. Serious complications are uncommon, but risk is never zero.

DBS is not intended to change personality. Cognitive status, depression, impulse-control problems and other psychiatric symptoms are assessed in detail before surgery.

In some patients, surgery, medication changes or unsuitable stimulation settings can cause temporary emotional or cognitive changes. Regular neurological, psychiatric and programming follow-up is therefore important.

Yes. DBS is adjustable and stimulation can be turned off when necessary. The system can also be removed surgically if appropriate.

The fact that the device can be removed does not mean that every effect of surgery is reversible. As with any operation, risks related to electrode placement cannot be completely reversed.

Some newer DBS systems are MRI-conditional, but the rules are not the same for every device, MRI scanner or imaging protocol.

A patient with DBS should not undergo MRI without consulting the treatment team. The imaging center must be told the make and model of the device, the system may need to be placed in MRI mode, and all manufacturer safety conditions must be followed.

Patients with DBS can travel, but security systems may affect some devices. Carry the device identification card and tell security staff that you have an implanted neurostimulator.

Depending on the device, manual screening may be requested. The patient controller should be carried in hand luggage.

Most everyday electronic devices do not cause important problems. Strong magnets, certain industrial equipment, welding equipment and some medical procedures may interfere with the system.

Before any operation, dental treatment, physical therapy or imaging procedure, healthcare staff must be told that a DBS device is present.

After healing, walking and suitable exercise are generally possible. Heavy lifting, intense physical activity and movements that may cause impact to the surgical areas should be avoided during the first weeks.

Advice from the treatment team is needed before contact sports, deep diving, unsupervised swimming or activities that carry a risk of significant impact to the chest or neck.

Timing depends on the type of work and the patient’s recovery. People with desk-based work may return earlier, while those doing heavy physical work may need a longer period of rest.

Daily activities should be increased gradually while wounds heal and medication and device settings stabilize.

Driving should not resume immediately after surgery. Timing depends on the underlying condition, seizure history, recovery and applicable legal requirements. Patients should not drive until approved by their neurology and neurosurgery team.

Yes. DBS is not completed by a single operation without further follow-up. Symptoms can change over time, requiring reprogramming, medication adjustment and battery checks.

Regular follow-up is important for maintaining benefit and recognizing possible problems early.

Benefit varies between patients and depends on patient selection, the condition, the brain target, electrode position, programming and individual response.

The aim before surgery is not to promise a definite result, but to explain realistically which symptoms are expected to improve, which may not improve and what risks treatment may carry.

No. Not every brain lesion is malignant. Benign conditions such as meningioma, pituitary adenoma, schwannoma and various cysts are also common. MRI findings, clinical status and, when needed, pathology are assessed together.

No. Some tumors can be followed with regular imaging. The decision depends on tumor growth, symptoms, location and the risks that may arise without treatment.

The aim is to remove as much tumor as is safely possible while protecting neurological function. A portion may need to be left when a tumor is close to areas responsible for speech, movement, vision or vital functions, in order to reduce the risk of permanent injury.

Yes. Depending on the condition, stereotactic biopsy, endoscopic surgery, endovascular treatment, Gamma Knife radiosurgery, radiotherapy or medication may be used. Some patients require a combination of more than one method.

Each plan is individualized. When needed, assessments from neurosurgery, radiology, radiation oncology, medical oncology, neurology and pathology are considered together.

No. Most spinal pain can be treated without surgery. Surgery is generally considered when there is nerve or spinal cord compression, progressive weakness, spinal instability or severe symptoms that continue despite other treatments.

No. MRI findings alone are not sufficient for a surgical decision. Imaging findings must be consistent with the patient’s symptoms and neurological examination.

No. In some patients, decompression alone is sufficient. Screws and rods may be needed when there is slippage, deformity, instability during movement or tumor-related bone loss.

Microscopic or minimally invasive techniques through small incisions may be used in suitable patients. Not every condition is appropriate for a minimally invasive approach; the method depends on the condition and the structural problem in the spine.

The main goal is to relieve pressure on the nerves or spinal cord and prevent neurological worsening. Arm or leg pain often improves sooner, while long-standing numbness or weakness may take longer. Complete relief of every symptom cannot be guaranteed.

New or rapidly worsening weakness in an arm or leg, inability to pass urine, loss of bladder or bowel control, or numbness around the genital area require urgent assessment. These symptoms may indicate severe nerve compression.

Treatment is planned individually. Symptoms, neurological examination, MRI or CT findings, age, general health and impact on daily life are considered together.