Gliomas are primary tumors that develop in the brain or spinal cord, that is in the central nervous system (CNS), starting from the "cells of the glia." They are quite common and are estimated to comprise about 40% of all CNS tumors. The factors responsible for the onset of the disease are not yet fully known, but it has been shown that the incidence is higher in people suffering from genetic diseases such as neurofibromatosis and tuberous sclerosis.
Treatment of gliomas: what are the possibilities?
Once the diagnosis of glioma has been ascertained, your doctor may suggest different types of treatment:
• Craniotomy surgery, to remove the tumor mass, and subsequent histological examination of the removed tissue;
• Surgery stereotactic biopsy, to reach tumors in deep positions or close to vital structures, and subsequent planning of the possible treatments;
• Radiotherapy and chemotherapy, to reduce or cure the tumor, depending on the degree of malignancy;
• Stereotactic radiosurgery with Gamma Knife, only for some patients with small tumors and in deep areas of the brain.
Among the possible treatments reserved for the treatment of gliomas by the brain surgery hospitals in India, surgery is the most frequent one, and it is perhaps also the one that over the years has evolved more consistently.
The intervention that involved the removal of the tumor mass under the microscope has been accompanied by a series of techniques and tools that allow the tumor to be located in a more precise way with positive results both in the pre-operative and operative phases.
Neuronavigator- Introduced 10-15 years ago, the neuronavigator is a tool that allows establishing the precise path inside the brain to get to intervene on the tumor mass without involving the so-called "noble" brain areas, i.e. those responsible for the control of movement or language. Its method of operation is similar to that of a car's GPS: in a special machine are inserted images of the patient's skull made by CT or MRI; these images are then reproduced by the neuronavigator at the three-dimensional level and used by the neurosurgeon to intervene even more precisely.
Cortical Mapping (Awake Surgery) - During the actual intervention, one of the last and most important novelties in the field of glioma surgery, and in general of cerebral surgery, is Cortical Mapping (Awake Surgery when it is done to the awake patient). As the English version of the term suggests, this technique foresees that the patient remains awake to be able to evaluate the involvement of important functional areas and their possible damage.
During the operation, the neurosurgeon stimulates different points of the cerebral cortex (depending on the location of the tumor) and asks the patient to perform some simple tasks such as moving an arm or leg, indicate an object present in the room and repeat some sentences. The patient's ability to perform one or more of these tasks tells the brain surgery hospitals in Delhi if and how much a functional area is at risk. Cortical mapping is generally used to treat tumors close to areas of movement and language.