Surgery for Glioma & Astrocytoma

Not every person with a glioma needs immediate surgery to remove the tumor. People with a low-grade glioma may simply require regular monitoring by their medical team, an approach called watchful waiting. Your doctor creates a plan that may involve follow-up visits and imaging scans, such as MRIs, every three to six months to monitor you for any signs that the tumor is growing or changing.

People with high-grade gliomas typically have surgery to remove the tumor, followed by radiation therapy and chemotherapy to eliminate any remaining cancer cells.

Perlmutter Cancer Center specialists have extensive experience in glioma surgery. They use advanced techniques to precisely guide the surgery, such as neuronavigation, the use of a computer during the procedure, and electrophysiological monitoring, sensitive electrical testing of affected nerves.

Our neurosurgeons are nationally known for their experience in treating brain tumors, including glioma and astrocytoma.

Surgery to remove a glioma is often guided by computer software that incorporates MRI and CT scans of the tumor. This technology helps surgeons pinpoint tumors and remove them with great precision while avoiding damage to the brain, including sensitive regions that control movement, language, hearing, touch, sight, smell, and taste. Perlmutter Cancer Center experts are developing and using newer techniques, like three-dimensional display of MRI imaging and virtual reality displays of the tumor.

Our doctors may also use functional mapping of important speech and motor areas of the brain to make surgery safer. Sometimes a person is awakened during surgery so that doctors can confirm that areas of the speech cortex are unaffected and that speech remains intact.

We are developing and using newer scanning techniques, such as three-dimensional MRI imaging and virtual reality displays of the brain tumor.

A team of clinical neurophysiologists—doctors who specialize in testing and assessing the central and peripheral nervous systems—monitors brain function during surgery to ensure the procedure does not affect any important nerves.


Neurosurgeons perform a craniotomy to remove as much of the glioma as possible while minimizing damage to the surrounding brain tissue. During this procedure, a surgeon makes an incision in the scalp and an opening in the skull to reach the brain, then removes as much of the growth as possible using extremely small microsurgical tools.

Dr. John Golfinos Performs Surgery

Dr. John Golfinos performs surgery.

A craniotomy usually requires general anesthesia. Depending on the location of the tumor, the surgeon may have the anesthesiologist wake you up during the procedure to check specific brain functions, such as speech and language. Waking up during surgery is painless, and our doctors prepare you for this approach ahead of time.

After surgery, a person typically remains in the hospital for a few days. During a brief stay in the neurosurgical intensive care unit, a specialized neurointensivist monitors neurologic function and helps manage any pain and other symptoms.

Some people may also benefit from inpatient neuro-rehabilitation at NYU Langone’s Rusk Rehabilitation, which can last a few days to a few weeks, depending on your symptoms and how well you respond to surgery.