Surgery for low-grade gliomas

What is Surgery for Low-Grade Gliomas?

Surgery for low-grade gliomas is a procedure performed to remove all or part of a slow-growing brain tumour known as a low-grade glioma. These tumours arise from glial cells, which support and protect nerve cells in the brain. Surgery is usually the first treatment for many low-grade gliomas because it helps confirm the diagnosis, reduce tumour size, relieve symptoms, and improve long-term outcomes.

When is Surgery for Low-Grade Gliomas Recommended?

Surgery for low-grade gliomas is recommended when the tumour is causing symptoms such as seizures, headaches, weakness, vision problems, or changes in memory and behaviour. It is also advised when imaging studies show tumour growth, pressure on surrounding brain tissue, or features suggesting a risk of progression to a higher-grade tumour. In many cases, surgery is performed to confirm the diagnosis through tissue examination and to remove as much of the tumour as safely possible, helping improve symptoms and long-term outcomes.

How Should I Prepare for Low-Grade Glioma Surgery?

Discuss the procedure, risks, benefits, and expected outcomes with your surgical team.
Sign consent form.
Attend all preoperative appointments and imaging studies.
Inform your doctor about medications, allergies, and medical conditions.
Stop certain medications, such as blood thinners, supplements, and fish oil.
Follow fasting instructions carefully.
Arrange transportation and support for recovery.

What Happens During Low-Grade Glioma Surgery?

Low-grade glioma surgery is usually performed by a neurosurgeon and may involve advanced technologies such as MRI-guided navigation, brain mapping, and intraoperative monitoring to improve accuracy and safety.

The surgery typically begins with anaesthesia, followed by a craniotomy, where a small portion of the skull is temporarily removed to access the brain. The surgeon then identifies the tumour and removes as much of it as safely possible. In tumours located near areas controlling speech, movement, or memory, an awake craniotomy may be performed so the patient can respond to questions or tasks during surgery, helping the surgeon avoid damaging critical brain regions. Once the tumour removal is completed, the surgeon replaces the skull bone and closes the incision with sutures.

In some cases, only a biopsy is performed if the tumour cannot be safely removed completely. The removed tumour tissue is then sent to a laboratory for microscopic and molecular analysis to confirm the diagnosis and guide further treatment.

What Happens After Low-Grade Glioma Surgery?

After low-grade glioma surgery, patients are monitored in the intensive care unit for complications such as swelling, bleeding, or neurological changes. Doctors assess speech, movement, memory, and overall brain function. Pain medications and anti-seizure drugs may be prescribed. Imaging scans are performed the next day to evaluate tumour removal. Recovery time varies, and rehabilitation may be needed for some patients. Depending on pathology results, additional treatments like radiation therapy, chemotherapy or newer targeted therapies may also be recommended.

What are the benefits of Low-Grade Glioma Surgery?

Removes as much of the tumour as safely possible.
Relieves symptoms such as headaches, seizures, and neurological deficits.
Reduces pressure within the brain.
Provides tissue for accurate diagnosis and treatment planning.
May improve survival and enhance the effectiveness of radiation and chemotherapy.

What are the Risks and Complications of Low-Grade Glioma Surgery?

Modern surgical techniques and careful monitoring help reduce the risk of serious complications.

Post operative blood clot causing pressure.
Swelling of the brain.
Seizures.
Neurological problems such as weakness, speech difficulties, or vision changes.
Hydrocephalus (accumulation of brain fluid)
Reactions to anaesthesia.
Incomplete tumour removal due to tumour location or spread into surrounding brain tissue.
Infection (brain, wound, urine, chest)
Complications related to other medical conditions (heart, lungs, kidney)
Clots in legs (Deep venous thrombosis) and clots in lungs (pulmonary embolus)

Note: Your surgeon will advise you on how likely the above complications are.

What can I expect when I am discharged from hospital

You may experience pain (including headache), inflammation, and discomfort in the operated area. Pain and anti-inflammatory medications are provided as needed.
Keep the surgical site clean. Instructions on surgical site care and bathing will be provided.
Refrain from smoking and alcohol until your first follow up visit as it can negatively affect the healing process.
Refrain from lifting anything heavier than 5 Kg and other strenuous activities until the first follow-up visit. These activities may include housework, yard work, gardening, mowing, etc.
Gentle exercise and regular walking are recommended to improve strength and endurance from 2 weeks after surgery.
Refrain from driving until you are fully fit and receive your surgeon’s clearance.
Most patients can return to their normal daily routines in 4-6 weeks after surgery.