Advanced Non-Invasive Treatment
Stereotactic Radiosurgery (SRS) on Long Island
Stereotactic radiosurgery — often called SRS — is a highly focused, non-invasive form of radiation treatment that delivers a precise, concentrated dose to a target inside the brain (or, in some cases, the spine) while sparing surrounding healthy tissue. Despite the name, no scalpel is used. For many patients with brain tumors, vascular malformations, or trigeminal neuralgia, SRS offers an effective alternative to traditional open surgery, with no incision, no general anesthesia, and same-day return home.
Dr. Symeon Missios, MD, FAANS, has extensive experience using stereotactic radiosurgery as part of a comprehensive neurosurgical practice on Long Island. He works closely with radiation oncologists and medical physicists at The Cancer Institute at Good Samaritan in West Islip to plan and deliver each treatment.
What Is Stereotactic Radiosurgery?
Stereotactic radiosurgery relies on a simple but powerful idea: many beams of radiation, each individually weak, are aimed from different angles so that they all converge at one precise point inside the brain. Where the beams cross, the radiation dose is high enough to destroy abnormal tissue. Outside that target, the dose drops off rapidly, sparing healthy structures.Because the target must be defined to within a millimeter, the patient is immobilized — usually with a custom-fitted facemask or, for certain treatments, a lightweight head frame — and high-resolution MRI and CT scans are fused to map the target in three dimensions.
Precision Targeting
Conditions Treated with SRS
Benefits of Stereotactic Radiosurgery
What to Expect: The SRS Treatment Process
Consultation
Dr. Missios reviews your imaging, medical history, and prior treatments, and discusses whether SRS, open surgery, or observation is the best fit. For cancer-related cases, the recommendation is made in coordination with your oncology team.
Planning Day
A custom immobilization device (typically a facemask) is fabricated. High-resolution MRI and CT scans are obtained and fused. The neurosurgery, radiation oncology, and medical physics team designs a custom treatment plan with multiple beam angles to focus the dose precisely on your target.
Treatment Day
Treatment is painless — most patients describe it as similar to having an MRI. Depending on the target and the technology used, a single session typically lasts 30 to 90 minutes. Most patients drive themselves home the same day.
Follow-Up
Follow-up MRI scans, generally at three-month intervals initially, are used to confirm tumor control. SRS does not typically shrink tumors immediately — the goal is to stop growth and often produce gradual shrinkage over months to years.
Stereotactic Radiosurgery vs. Traditional Surgery
SRS and open surgery are complementary tools, not competitors. Open surgery is generally preferred when there is significant mass effect, when tissue diagnosis is needed, or when a tumor is too large for safe radiosurgery.
SRS is often preferred for small, well-defined lesions, deep or hard-to-reach targets, multiple metastases, or patients who are not good candidates for open surgery.
In many cases, the two are combined — for example, surgical removal of a large tumor followed by SRS to the surgical bed.
Why Patients Choose Dr. Missios for SRS
Frequently Asked Questions
No — there is no incision and no scalpel. The word ‘surgery’ refers to the surgical-level precision with which radiation is delivered. SRS is technically a form of highly focused radiation therapy.
Most single-session SRS treatments take between 30 and 90 minutes, including setup. Planning and imaging are typically done on a separate day before treatment.
Most patients tolerate SRS very well. Possible short-term side effects include mild headache, fatigue, or scalp irritation at the immobilization sites. Serious side effects are uncommon and depend on the location and size of the target. We review specific risks for your case during consultation.
SRS is designed to stop abnormal cell growth rather than physically remove tissue. Tumors typically stabilize within weeks and may shrink gradually over months to years. Follow-up MRI is used to monitor response.
Stereotactic radiosurgery is covered by most major insurance plans when it is medically appropriate. Our office staff will verify your coverage and explain expected costs before treatment is scheduled.
Schedule a Stereotactic Radiosurgery Consultation on Long Island
If you or a loved one has been told you may need stereotactic radiosurgery, you deserve a clear, unhurried conversation with a board-certified neurosurgeon who will explain every option — including whether surgery is truly the right path. Dr. Missios sees patients at three convenient Long Island locations and offers second-opinion consultations.