This technique was developed when several centers who used linear accelerator irradiation technology were not satisfied with the results or accuracy after single fraction irradiation (radiosurgery). To decrease the cranial nerve morbidities, radiation was delivered over multiple sessions (fractionation). The goal of this approach is to weaken the effect of each radiation administration and try to maintain brain or nerve function. This also weakens the effect of the radiation on the tumor target.

This technique is a stereotactic radiosurgery using the Gamma Knife (Elekta Instruments, Atlanta GA) supplemented with local anesthesia and intravenous sedation.

It is important to observe the development of the tumor before beginning any form of treatment. Surgical Resection is done to remove the tumour. Depending on the goal of the treatment, severity and size of the tumour, three kinds of routes can be taken : suboccipital retrosigmoid, translabyrinthine approach (for large tumours) and "middle fossa" approach. The goal could be life saving, or avoiding neurological deficits like hearing loss, facial weakness or balance disorders.