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Surgical Techniques

  • Chapter
High-Grade Gliomas

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

The development of surgical navigation systems (SNS) has revolutionized the surgical management of high-grade glioma. The most common procedures using this technology are biopsy and craniotomy. Biopsy is often the procedure of choice when a histological diagnosis is desired, or when open resection is too risky or unnecessary. Stereotactic biopsy has low morbidity, high rates of diagnosis (albeit with a small risk of undergrading HGG), and may provide tissue for both histologic and molecular diagnoses. SNS may also be used to placed catheters for cyst drainage, brachytherapy, and convection enhanced delivery—a relatively new technique for infusing therapeutic agents through the brain. Extent of resection is becoming increasingly recognized as important to outcome in HGG. Navigation may be used to locate or tailor the bone flap, locate the tumor, or assist with assessment of resection completeness. It is important for the surgeon to consider the impact of gross brain movement due to loss of cerebrospinal fluid (so-called brain shift) as well as local tissue distortions when navigating using preoperatively acquired imaging. With proper care, use of SNS can limit morbidity and enhance resection for some patients with HGG.

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  1. The Brain Tumor Institute, Department of Neurological Surgery, The Cleveland Clinic Foundation, Cleveland, OH

    Gene H. Barnett

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  1. Department of Neurological Surgery Cleveland Clinic Foundation, Brain Tumor Institute, Cleveland, OH

    Gene H. Barnett MD

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Barnett, G.H. (2007). Surgical Techniques. In: Barnett, G.H. (eds) High-Grade Gliomas. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59745-185-7_12

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