What is a glioma?

A glioma is a type of brain tumour that starts within the glial cells. This is the supportive tissue of the brain. There are three main types of gliomas, which include:

• Astrocytoma – these start from the astrocyte cells, which regulate the electrical impulses in the brain

• Oligodendroglioma – these start from the oligodendrocyte cells, which insulate the nerve cells in the brain

• Ependymoma – these start from the ependymal cells which line the cavities of the brain (ventricles)

Astrocytomas are the most common type of gliomas (brain tumours) that are found in adults and children. This type of brain tumour can occur in any part of the brain and nervous system, meaning that they can be found in the spinal cord.

Gliomas are graded from 1-4 depending on how severe and dangerous they are. A grade 4 glioma is the most aggressive form. The treatment that patients are offered will different depending on the grade of the tumour.

A craniotomy is the most common type of surgery that is used to remove a brain glioma. To reach the affected area, the surgeon will remove an area of skull, which is referred to as a ‘flap’. Scans will be taken before the surgery, which will then be used by the surgeon to get the accurate location and ensure they remove as much of the tumour without taking any healthy tissue. The ‘flap’ is then put back in place and secured with a small metal bracket. The scalp is then stitched back together and the patient will be sent to the ward to recover.

Depending on the location of the brain glioma, the surgeon may suggest having an awake craniotomy instead. This is offered to patients who have a tumour that is close to a part of the brain that controls an important function such a speech. The surgeon will do this to test a certain function during the surgery to check that is it still ok, the patient may be asked to speak. It is important to note that the patient will not feel anything. An interesting fact about the brain is that it does not feel pain, so although an awake craniotomy may seem scary, the team around the patient will ensure that they experience no pain.

Neuroendoscopy is a minimally invasive technique, also known as keyhole surgery, which requires a much smaller opening to get to the brain and site of the tumour. An endoscope, which is made up of a long tube, camera and small surgical instruments, is passed through the small opening. The camera image is put onto a screen in the theatre, which will be used by the surgeon as a guide to remove the tumour. This is a much less invasive surgery, and therefore means that the patients can have a speedier recovery. This type of surgery is very useful for removing ependymomas in the ventricles, which is a fluid filled space in the brain.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.