Dr. Gary Steinberg

You focus it on a very small area and you can eliminate vascular malformations called arteriovenous malformations, tumors.

You can even use it for some pain conditions like trigeminal neuralgia.

It's not risk-free because even though radiation doesn't require opening the skull, it still is a form of energy that's damaging.

That's how it works.

It causes, for the AVMs, it gradually clots off the blood vessels.

But it's much easier and much safer than some of the invasive techniques that we use.

We operate now through tiny openings, even when we do open surgery.

When I trained, we used to shave the whole head.

We would open a huge area of the skull.

Now we operate through tiny areas, very small areas.

When I take out vascular malformations in the brainstem, for instance, I sometimes operate through openings in the side of the brainstem that are two to three millimeters.

Another form of non-invasive treatment that neurosurgeons use is called focused ultrasound.

Again, you don't have to open the skull.

It focuses sound waves on areas of the brain.

We're using that to treat essential tremor or Parkinson's disease.

It's starting to be used for treating tumors.

So these are all advances that were not present when I trained.

Another way of treating minimally invasive, although it still requires a hole in the head, is to put in an electrode and stimulate the brain.

So that was first used for treating Parkinson's disease, very effective for medically intractable Parkinson's.

It's used to treat chronic pain.