Dr. Brisman is proficient in the use of stereotactic radiosurgery, Gamma Knife, Cyberknife, Novalis Tx, microvascular decompression, transsphenoidal surgery, stereotactic-guided craniotomy, and percutaneous trigeminal rhizotomy.

“Selection of the different types of radiosurgery equipment for hospitals is based on factors such as the general population size, the severity of indications, including brain metastases, AVMs, trigeminal neuralgias and other complications for which strong neurosurgical or oncological referrals are available,” said Brisman who is also the co-medical director of Long Island Gamma Knife, and chief of surgical neuro-oncology at South Nassau Communities Hospital.


“A strong referral base is essential for Gamma Knife intervention, and therefore, small and medium-sized hospitals are better off using the other LINAC modalities instead," he added. Further, linacs can be used for other parts of body such as prostate and spine, whereas Gamma Knife is indicated exclusively for brain lesions.

Benign and malignant brain lesions can be treated using stereotactic imaging and frameless motion management system safely and effectively, although the proximity to critical structures such as brain stem or optic nerve determines the tolerance limits and outcomes, explained Brisman.

In any case, he added, the risks and complications associated with Gamma Knife, Cyberknife or linacs are all minimal compared with traditional radiation therapy or operation.

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