Glioma
Glioma is a primary central nervous system tumour arising from glial cells — astrocytes, oligodendrocytes, and ependymal cells. Gliomas are classified by WHO grade (I–IV), with grade IV glioblastoma being the most aggressive and most common malignant primary brain tumour in adults.
Understanding Glioma
Gliomas account for approximately 30 per cent of all primary brain tumours and 80 per cent of malignant primary brain tumours. They arise from the supporting glial cells of the brain and infiltrate the surrounding tissue along white matter tracts, making complete surgical resection challenging. The WHO classification integrates histological features and molecular markers — IDH mutation status, 1p/19q codeletion, MGMT promoter methylation — which stratify prognosis more accurately than histology alone. IDH-mutant gliomas have a significantly better prognosis than IDH-wildtype tumours of the same grade.
Surgical resection is the cornerstone of glioma treatment. The goal is maximal safe resection — removing as much tumour as possible while preserving neurological function. Intraoperative mapping techniques allow surgeons to resect tumour tissue up to the border of eloquent brain regions. For international patients, Istanbul offers rapid access to high-volume neuro-oncological surgery with advanced surgical adjuncts at a fraction of Western costs.
Treatment Options for Glioma
View All ProceduresSymptoms of Glioma
Symptoms depend on the tumour location, size, and growth rate. Slow-growing low-grade gliomas may present with new-onset seizures in an otherwise healthy adult — this is the most common presenting symptom for grade II tumours. Headaches, particularly those worse in the morning or exacerbated by coughing, are common. Focal neurological deficits — hemiparesis, aphasia, visual field cuts, sensory loss — correspond to the involved brain region. Cognitive changes, personality changes, and memory impairment are frequent, especially with frontal lobe involvement. High-grade gliomas may present with rapidly progressive symptoms over weeks to months, including raised intracranial pressure with nausea and vomiting.
Diagnostic Pathways
MRI with gadolinium contrast is the primary imaging modality. Low-grade gliomas typically appear as T2/FLAIR hyperintense masses without enhancement; high-grade gliomas show irregular ring enhancement with central necrosis and surrounding vasogenic oedema. MR spectroscopy, perfusion MRI, and diffusion-weighted imaging provide additional metabolic and haemodynamic information that helps differentiate tumour grade and guide biopsy planning. Stereotactic biopsy is performed for tumours in eloquent or deep locations to obtain tissue for histopathological and molecular analysis. WHO classification integrates histology with IDH1/2 mutation, ATRX loss, 1p/19q codeletion, MGMT promoter methylation, and TERT promoter mutation status.
Advanced Treatment Options at Vellum Select
Craniotomy and Microsurgical Resection
Maximal safe surgical resection is the first and most critical step in glioma treatment. Craniotomy (Brain Surgery) in Turkey at Vellum Select is performed by Prof. Dr. Türker Kılıç using intraoperative neuromonitoring, neuronavigation, and in selected cases, awake craniotomy with cortical mapping to maximise resection while preserving speech, motor, and sensory function. The extent of resection is the strongest modifiable prognostic factor in both low-grade and high-grade gliomas.
To discuss your glioma diagnosis with Prof. Dr. Türker Kılıç, view his profile or contact Vellum Select to arrange a consultation.