A system of stereotactic radiosurgery using a linear accelerator is described and the experience with a variety of neurosurgical lesions including gliomas, acoustic neurinomas and arteriovenous malformations is recorded. The system is simple, inexpensive and effective and can be used with any CT scanner and linear accelerator.

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Stereotactic linear accelerator (linac) radiosurgery has been in operation in the West Midlands since 1987, the first of its kind in the United Kingdom. Forty two patients with high-flow cerebral arteriovenous malformations have been treated, 26 of whom have been followed up. Angiography one year after treatment showed that five lesions were obliterated, 11 were reduced in size and/or flow rate and 10 were unchanged. Overall results show that nine out of 10 patients reviewed at 24 months had total obliteration. Three patients had complications; one has fully recovered, one died of an unrelated cause at 36 months and the other died from recurrent haemorrhage at nine months.

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