Everything in the world has two sides, cranial gamma knife is no exception. In addition to the many advantages of cranial gamma knife, gamma knife treatment and craniotomy also has its own shortcomings and shortcomings, these shortcomings and shortcomings are mainly determined by the mechanism and characteristics of its treatment. Mainly in the following aspects: (1) the efficacy of slow: I think this understanding of cranial gamma knife treatment is more appropriate: the end of gamma knife treatment is not the end of the disease treatment, but the beginning of the disease treatment. This is because after gamma knife treatment, the target area tissue (lesion) radiobiological effects can last 2 to 3 years or even longer, except for very few diseases with relatively fast efficacy, most of the rest of the disease efficacy is relatively slow. Gamma knife real treatment time of only about an hour, the next day after treatment can be discharged from the hospital, the patient efficacy, disease observation, recovery period is mainly completed at home. This requires patients to closely observe the changes in their condition for at least the next three years after receiving Gamma Knife treatment, to regularly visit the hospital for review, to understand the changes in the lesion, and to patiently wait for the curative effect. (2) Cannot be used for emergency treatment: Because the effect of gamma knife is slow, it cannot be used for emergency treatment. This also determines that gamma knife in the treatment of brain tumors is only applicable to patients who have not yet caused a significant increase in intracranial pressure. In contrast, emergency is the specialty of craniotomy, which can quickly remove or partially remove the tumor, relieve the occupying effect, lower the intracranial pressure, and play an immediate effect, thus achieving the purpose of emergency. (3) The doctor’s feeling is not as real as that of craniotomy: the main surgeon of craniotomy is the core of the whole operation, and the doctor is very active in every step of the operation, and needs to deal with the problems arising in the operation at any time. Is the tumor removed cleanly or not? How much has been removed? Even the possible consequences of the main surgeon’s mind are more clear. Gamma knife doctor is different, in addition to the doctor needs to accurately grasp the different points of individual patients for treatment, cranial gamma knife treatment process is more programmed, automated, standardized. The entire treatment process is carried out as required, and the doctor’s operational treatment level is mainly expressed in the selection of indications and the development of the treatment plan, which is then implemented by the machine and is relatively less challenging, unlike surgery which is as real and more challenging. After the treatment is completed, the gamma knife doctor can not be as soon as the surgery can be roughly judge the effect of treatment, only through the future review to judge and evaluate.