Gliomas arise from the brain’s own glial cells and infiltrate into surrounding healthy tissue rather than forming a distinct mass. Because the boundary between tumor and normal brain is often invisible under traditional visualization alone, glioma surgery<\/a>\u00a0demands exceptional surgical planning, advanced technology, and extensive experience to maximize safe tumor removal while minimizing neurological risk. <\/p>\n Why Glioma Classification Changes the Surgical Strategy <\/p>\n Gliomas are the most common tumors arising from the brain and spinal cord itself. The World Health Organization classifies them into four grades based on microscopic appearance as well as molecular and genetic characteristics. Understanding the tumor’s grade is critical because it directly influences treatment recommendations and surgical goals. <\/p>\n Grade I gliomas are generally slow growing and are often curable with complete surgical removal when their location permits. <\/p>\n Grade II gliomas also grow slowly but infiltrate healthy brain tissue and may transform into higher-grade tumors over time. Surgery is frequently the most important initial treatment because it may delay progression while relieving neurological symptoms. <\/p>\n Grade III gliomas grow more aggressively and invade surrounding brain tissue, making complete removal difficult. The amount of tumor safely removed during surgery can significantly influence the effectiveness of subsequent radiation therapy and chemotherapy. <\/p>\n Grade IV gliomas, including glioblastoma, represent the most aggressive form of brain tumor. Although surgery cannot cure these tumors because of their infiltrative growth pattern, maximizing safe tumor removal remains one of the most important factors associated with improved survival and quality of life. <\/p>\n Story Continues <\/p>\n Because a glioma’s grade cannot always be determined with certainty until tissue is examined after surgery, and because tumors may behave differently than imaging alone suggests, selecting the appropriate surgical strategy requires substantial experience treating these highly complex brain tumors. <\/p>\n Advanced Surgical Technologies That Help Define the Tumor Boundary <\/p>\n One of the greatest challenges in glioma surgery is distinguishing infiltrating tumor cells from healthy brain tissue. Removing too little leaves tumor behind, while removing too much can permanently affect speech, movement, sensation, vision, or other neurological functions. Throughout his career, Dr. Cohen-Gadol has helped refine technologies designed to improve that balance. <\/p>\n Fluorescence-guided tumor resection. Dr. Cohen-Gadol helped refine fluorescence-guided imaging techniques that allow glioma tissue to fluoresce under the operating microscope, enabling surgeons to identify tumor margins more accurately than relying on conventional visualization alone. <\/p>\n Intraoperative mass spectrometry for real-time margin assessment. Research published by Dr. Cohen-Gadol in the Proceedings of the National Academy of Sciences\u00a0demonstrated the use of desorption electrospray ionization mass spectrometry to provide molecular analysis of tissue during surgery, helping surgeons better assess tumor margins in real time. <\/p>\n Awake brain mapping. For tumors located near areas responsible for speech, movement, or sensation, Dr. Cohen-Gadol utilizes awake brain mapping techniques that identify functional brain tissue during surgery, helping maximize tumor removal while protecting neurological function. <\/p>\n Advanced AI-assisted surgical planning. Artificial intelligence combined with sophisticated three-dimensional surgical simulation allows Dr. Cohen-Gadol to evaluate each tumor’s relationship to critical white matter pathways, blood vessels, and functional brain regions before surgery. This detailed planning helps identify the safest surgical corridor and supports the goal of achieving the most complete safe resection possible. <\/p>\n “With gliomas, surgery is never simply about removing a tumor,” said Dr. Cohen-Gadol. “It is about removing as much tumor as possible while protecting the neurological functions that define a patient’s quality of life. The fluorescence-guided, mapping-guided, and planning technologies we have helped develop all exist for that purpose. For nearly every grade of glioma, maximizing safe resection can have a meaningful impact on treatment options, survival, and long-term outcomes.” <\/p>\n Why Patients Travel for This Specialized Glioma Surgery Expertise <\/p>\n Dr. Cohen-Gadol has performed more than 7,500 complex brain surgeries, among the highest case volumes of any practicing neurosurgeon in the United States, treating patients with the full spectrum of gliomas, from pediatric low-grade tumors to adult glioblastoma. <\/p>\n As founder of the Neurosurgical Atlas, an educational resource used by more than 70,000 physicians and surgeons worldwide, Dr. Cohen-Gadol continually studies, refines, and teaches the same advanced microsurgical techniques he performs in the operating room. <\/p>\n Dr. Cohen-Gadol is among a select group of neurosurgeons worldwide to receive the Vilhelm Magnus Medal from the Scandinavian Neurosurgical Society for contributions that have advanced neurosurgical care internationally. <\/p>\n His practice provides comprehensive virtual second-opinion reviews of imaging and pathology, allowing patients and families to determine whether traveling to Los Angeles for evaluation or surgery is appropriate before making travel arrangements. <\/p>\n A Second Opinion Before Booking a Flight <\/p>\n Dr. Cohen-Gadol performs surgery at Cedars-Sinai Medical Center and Saint John’s Health Center in Los Angeles, where he leads the ATLAS Institute of Brain and Spine. His practice offers both in-person consultations and virtual second opinions, allowing patients anywhere in the world to have their imaging and pathology personally reviewed before deciding whether travel for treatment is appropriate. <\/p>\n Patients newly diagnosed with a glioma, including glioblastoma or lower-grade gliomas, as well as families seeking a second opinion regarding treatment options, can contact Dr. Cohen-Gadol’s office at (310) 626-1312 or visit https:\/\/www.atlasneurosurgeryinstitute.com\/<\/a> to submit imaging or schedule a consultation. <\/p>\n About Dr. Aaron Cohen-Gadol <\/p>\n Dr. Aaron Cohen-Gadol is an internationally recognized neurosurgeon specializing in complex brain tumors, skull base surgery, cerebrovascular disorders, spinal cord tumors, cavernous malformations, and arteriovenous malformations. He is founder and director of the ATLAS Institute of Brain and Spine in Los Angeles. <\/p>\n Over the course of his career, Dr. Cohen-Gadol has performed more than 7,500 complex brain surgeries, authored more than 600 peer-reviewed scientific publications, pioneered more than 40 novel surgical techniques, and helped advance fluorescence-guided and mass spectrometry-guided brain tumor surgery. He is the recipient of the Vilhelm Magnus Medal from the Scandinavian Neurosurgical Society and founder of the Neurosurgical Atlas, an educational platform used by more than 70,000 physicians and surgeons worldwide. <\/p>\n Media Contact<\/a> Atlas Institute of Brain & Spine <\/p>\n
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