Lars Lerksell and the Birth of Stereotactic Radiosurgery: From Vision to Global Standard in Neurosurgery

Introduction: Gamma Knife radiosurgery (GKRS) has revolutionized the field of neurosurgery, offering a non-invasive and precise approach to treating a variety of intracranial lesions. This research delves into the historical development of GKRS, from its conceptualization by Lars Leksell to its widespread clinical application today.

Methods: This historical vignette involved analyzing primary sources, including Lars Leksell’s publications and biographical accounts, as well as secondary sources documenting his collaboration with physicist Börje Larsson. Key technological milestones, such as the development of the stereotactic frame and cobalt-60 integration, were studied to understand the Gamma Knife’s evolution. Thematic analysis was used to identify key themes, including the conceptualization of radiosurgery, technical development, clinical applications, and impact on neurosurgery.

Results: The conceptualization of GKRS can be traced back to the visionary work of Lars Leksell, who sought a less invasive approach to treating brain lesions. In collaboration with physicist Börje Larsson, Leksell developed the first Gamma Knife in 1967. This pioneering device utilized multiple cobalt-60 sources to deliver highly focused radiation to precise brain targets.
Subsequent advancements in technology over decades have significantly enhanced the capabilities of GKRS. The integration of frameless stereotactic systems and real-time image guidance has improved treatment accuracy and patient comfort. Additionally, advancements in radiation delivery techniques have enabled more precise targeting of lesions while minimizing damage to surrounding healthy tissue.
Presently, GKRS has a broad range of clinical applications, including the treatment of brain tumors, arteriovenous malformations, trigeminal neuralgia, and functional disorders. The widespread adoption of GKRS is attributed to numerous clinical trials and long-term studies demonstrating its safety, efficacy, and minimal side effects.

Conclusion : GKRS has evolved into a powerful tool in the neurosurgeon's arsenal. Its historical development and ongoing advancements continue to shape the future of neurosurgical treatment, offering hope to patients with a variety of intracranial conditions.