There are three surgical procedures that may be performed on patients with gliomatosis cerebri. All of these are best performed by highly skilled neurosurgeons with experience in rare brain tumors. Younger patients with gliomatosis cerebri may be seen by a pediatric neurosurgeon who specializes in brain tumors in children and young adults. (See Doctors Who Treat Gliomatosis Cerebri.)
Surgical biopsy: The first surgery a patient may have is a biopsy, to extract a sample of the tissue to determine what it is. Most cases of gliomatosis cerebri can be biopsied easily.
Resection (removal): A highly skilled pediatric neurosurgeon will perform a craniotomy to remove a portion of the skull to gain access to the tumor to remove it. The goal of the surgery is to remove as much of the tumor as possible without damaging healthy brain tissue. In other areas of the body, surgeons remove not just a tumor but a small margin of healthy tissue around it to capture any stray cancer cells. That’s not possible in the brain, where removing healthy tissue can cause neurological deficits (motion, speech, or other functions). The skill and training of the neurosurgeon is critical to how much of the tumor can be removed.
Shunt placement/revision: A tumor may be blocking the normal flow of cerebrospinal fluid (CSF), leading to a buildup of pressure in the brain (hydrocephalus). A neurosurgeon can place a temporary drain, called a ventriculostomy or external ventricular drain (EVD), to relieve pressure. An internal shunt is a more permanent solution – it drains CSF into the patient’s abdomen, where it is absorbed into the body. Shunts may sometimes need to be repositioned to continue to drain effectively, which is called a shunt revision.
At the Weill Cornell Medicine Brain and Spine Center, our adult and pediatric neurosurgeons are highly skilled in the most advanced procedures for treating rare brain tumors like gliomatosis cerebri. Use our online form to request an appointment for an evaluation or second opinion.
Reviewed by: Jeffrey Greenfield, Ph.D., M.D.
Last reviewed/last updated: April 2021