Dr. Spetzler planned to remove the AVM in two surgeries, but during the first surgery, he found that the AVM was so large and complex and located in such a critical area that removing it would likely result in brain damage. Instead, he reduced the size of it, restricting blood flow significantly. Afterward, Lauri returned to Barrow for yearly MRIs and angiograms.
When Barrow opened its Gamma Knife Center in 1997, Dr. Smith suggested Gamma Knife as a treatment for Lauri's AVM.
"I was pretty excited because they were
optimistic about it eliminating my AVM, and it was noninvasive,"
Lauri says.
On March 17, 1997, Lauri became the first patient to receive Gamma
Knife treatment. First, Gamma Knife specialists attached a
lightweight frame, called a stereotactic headframe, to Lauri's
head. The frame enables physicians to do the precise planning
necessary for Gamma Knife treatment and to position the patient's
head during treatment. Then, neuroradiologists did a special
MRI scan that produced images of every millimeter of Lauri's
brain. These 144 images were sent to the Gamma Knife computer
and used to create a map of her brain, allowing Dr. Smith to
precisely define the treatment target area and plan the
treatment.
During treatment, Lauri's headframe was positioned in a metal helmet with 201 holes. Through those holes, beams of cobalt-60 radiation were focused on the AVM in Lauri's brain. Gamma Knife specialists adjusted the position of Lauri's headframe in the helmet 17 times, thus ensuring that the doses of radiation exactly conformed to the AVM.
According to Dr. Smith, the average time between treatment by Gamma Knife and cure of an AVM is two to three years.
"The Barrow is the ultimate place to go in the U.S.," says Lauri. "Whenever I hear of someone with a neurological problem, I say, 'You should go to Barrow.' I think Dr. Smith and Dr. Spetzler are the absolute best."
