Just a little additonal info/experience:
-- Unless your friend has trouble as an airplane passenger now (perhaps because of balance problems), I don't think she'd have problems after radiation 'surgery'. Don't know about after microsurgery.
-- I had Gamma Knife on 1.6cm AN. (58 years old). My understanding is that Cyberknife is the newer technology that pinpoints tumor even more precisely than GammaKnife. On the other hand, GammaKnife has been around longer ... originated in the '60's I believe, used regularly since the '80s. Whereas Cyberknife is newer. So it's sort of the classic decision between "latest technology" and "used on more people". Steve had Cyberknife and knows alot about this debate.
-- My symptoms were and are unilateral hearing loss (but not complete hearing loss), imbalance and tinnitus. My GammaKnife was July 2007 and symptoms have remained the same. What I want to communicate is that I don't expect them to necessarily IMPROVE; I'll just be happy if they stay the same. It isn't expected that radiology will SHRINK the tumor, only that it will KILL the tumor so it doesn't grow.
-- I have no experience with the vision problems (...well, I have horrible eyesight, but that doesn't have to do with the AN !!). If I did, that would be a major concern and I'd seek out opinions on best way to cure or at least halt those problems. I do know that the facial problems can be a direct result of the AN itself and/or a negative result of microsurgery, although I would say unequivocally that any good AN microsurgeon is going to use facial monitoring equipment and personnel DURING SURGERY to do the best he/she can to NOT cause facial problems. I think it's fair to say that everyone here would agree with that statement. I don't know if your friend's eye problems are related to eyelid problems, but those seem to be some of the most irksome of the facial problems.
-- My two cents: as you've noticed, there's a tendency toward recommending microsurgery over radiation for younger folks because of the possibility that radiation might cause other problems decades later. I really think your friend needs to proceed according to what her "gut" tells her about this .... people have been having radiation via GammaKnife for 30-40 years now, and I've seen no reports of additional tumors arising. If your friend has a great fear that radiation might be bad decades down the road, then she should follow that gut feeling. But if her intuition is that it won't cause problems, then I'd tell her to discount that argument.
--NOW I do want to say I'm very 'prejudice' toward radiation 'surgery' because I think it's SO much easier on the body, BUT that's me and my experience with others in my family having brain microsurgeries. So please take that into account when considering what I say!
Well, that's my two cents. I hope your friend is able to take some deep breaths and consider all her alternatives patiently. I think most of us struggle and feel overwhelmed by it all, but ... when we come to our decision, we KNOW it's the right one. Your friend is very lucky to have a friend who will help her sort through all the info, so she can come to the decision that makes sense for all her factors, rational "factual" ones as well as subjective ones.