The Children’s Gamma Knife Centre

The Children’s Gamma Knife Centre (CGKC) is a joint enterprise between Great Ormond Street Hospital (GOSH), University College London Hospitals (UCLH) and the Queen Square Radiosurgery Centre (QSRC). Uniquely, it is a service designed for delivery of stereotactic radiosurgery (SRS) solely for children.

It is led byMr Greg James, Consultant Neurosurgeon at GOSH, and Mr Neil Kitchen, Consultant Neurosurgeon at UCLH. CGKC is commissioned by NHS England as provider for all children’s SRS for the South of England.

SRS, often known by the trade name “Gamma Knife", is a form of highly selective radiation therapy, used to treat problems in the brain including vascular malformations and certain tumours.

It works by a process called collimation - a bit like a special colander with tiny holes that can be opened and closed - and stereotaxy - a process to accurately locate targets in the brain with sub-millimetric accuracy. Using these techniques and advanced planning software, a large radiation dose can be delivered to a small target, with very little “leakage” of radiation into the surrounding healthy brain.

Unlike conventional radiotherapy, most treatments can be completed in a single session, and side effects at the time of treatment such as hair loss and tiredness are extremely rare.

The CGKC is a unique partnership which means that children and their families get access to experts from both GOSH and UCLH to ensure their treatment is safe and effective.

After referral, children and their families meet Mr James and Mr Kitchen in a dedicated joint clinic held at GOSH. If, following this consultation, the decision is made to proceed, children have a pre-operative visit to meet the team, including the clinicians involved on the day of treatment and the play team if appropriate.

On the day of treatment, children are admitted to GOSH before being taken a short walk across to the National Hospital by their dedicated children’s nurse and play worker.

Treatments are performed under general anaesthetic, which is performed by a dedicated GOSH children’s anaesthetic team, who stay with the child during the entire treatment.

The necessary steps, including scans and treatment, are carried out by the combined team including Mr James and Mr Kitchen, before the child is brought back to wake up in the company of their family in the dedicated children’s recovery unit at GOSH.

• Arteriovenous malformations
• Vein of Galen malformations
• Cavernoma
• Intracranial tumours

Most children with a condition suitable for SRS will already be cared for by a specialist team who will send a medical letter and scan pictures to GOSH for assessment. Each child’s case is discussed in a special meeting and any decisions made are sent to the referring doctor and copied to the family.

If you think your child may benefit from SRS treatment, discuss with your local specialist whether he or she thinks it would be appropriate. The CGKC team are happy to discuss individual cases with local specialists if clarification is required.

The CGKC accepts NHS and private referrals. International and private patients can contact CGKC directly via the IPP office.

Referrals can be sent to Mr Greg James, for details click here. All referrals are discussed at the appropriate GOSH multidisciplinary meeting as well as the UCLH Gamma Knife multidisciplinary meeting and referrers will receive a written decision whether or not an individual case is accepted for treatment.

Informal discussions are encouraged - Mr James and Mr Tisdall can be contacted via switchboard to discuss suitability of individual cases. The CGKC accepts NHS and private referrals.