Brain Tumors & Neuro-oncology
Brain tumors, whether primary or metastatic, require a precise, individualized treatment approach. Dr. Kassam and his team combine advanced surgical techniques with multidisciplinary oncologic care to address tumors across the full spectrum of complexity and location.
Understanding Brain Tumors
Brain tumors can be benign or malignant, primary (originating in the brain) or metastatic (spreading from another part of the body). Treatment planning depends on the tumor's type, grade, location, and its relationship to critical brain structures. Some tumors are accessible through conventional approaches, while others, particularly those in deep or critical areas, require specialized minimally invasive techniques.
Types of Brain Tumors
Gliomas
The most common primary brain tumors, arising from glial cells. Include astrocytomas, oligodendrogliomas, ependymomas, and glioblastoma (GBM).
Meningiomas
Tumors arising from the meninges, the protective membranes surrounding the brain. Usually benign but can cause significant compression of surrounding structures.
Medulloblastomas
Malignant tumors most commonly occurring in children, typically arising in the cerebellum.
Schwannomas
Tumors arising from the nerve sheath, most commonly affecting the vestibular nerve (vestibular schwannoma/acoustic neuroma).
CNS Lymphomas
Rare lymphomas arising within the central nervous system.
Metastatic Brain Tumors
Tumors that have spread to the brain from cancers elsewhere in the body, such as lung, breast, melanoma, or colon.
Signs & Symptoms
Symptoms depend on the tumor's size, location, and rate of growth. Common signs include:
- Headaches, particularly new or worsening patterns
- Seizures, including new-onset seizures
- Cognitive changes: memory difficulties, confusion, personality changes
- Vision or speech difficulties
- Weakness or numbness on one side of the body
- Nausea and vomiting
- Balance and coordination problems
Any new or persistent neurological symptoms should be evaluated promptly. Early diagnosis improves treatment options and outcomes.
Diagnostic Approach
Accurate diagnosis and detailed surgical planning are essential for optimal outcomes. Dr. Kassam and his team use advanced imaging and clinical evaluation to understand each tumor's characteristics:
- Comprehensive neurological examination
- MRI with diffusion tensor imaging (DTI) and 3D tractography
- CT angiography (CTA)
- PET imaging for metabolic assessment
- Biopsy when needed for definitive tissue diagnosis
- Advanced brain mapping using DTI and tractography to understand the tumor’s relationship to critical white matter pathways
- Digital subtraction angiography (DSA), in select cases
Dr. Kassam's Approach
Dr. Kassam and his team employ a range of advanced techniques tailored to each tumor's location and characteristics:
For skull base tumors: Endoscopic endonasal surgery provides access through the nasal passages, avoiding external incisions.
Learn about the EEA→For deep-seated tumors: Minimally Invasive Parafascicular Surgery (MIPS) navigates through the brain’s natural folds to reach tumors once considered inoperable, preserving healthy tissue and critical fiber pathways. Dr. Kassam and his team developed this technique.
Learn about parafascicular surgery→For tumors near eloquent areas: Conscious brain surgery allows real-time monitoring of language, motor, and cognitive function during tumor removal.
Learn about conscious surgery→Brain mapping: Advanced DTI and tractography create a personalized 3D model of each patient’s brain, enabling precise surgical planning. A dedicated neuro-radiologist collaborates with the surgical team and accompanies surgeons into the operating room for real-time guidance.
Learn about brain mapping→Exoscopic robotic visualization: High-definition digital cameras on a robotic arm, controlled by voice commands and directed by the patient’s brain map, provide enhanced tissue-specific visualization during surgery.
Learn about robotic neurosurgery→GammaTile Therapy
For select brain tumor cases, surgically targeted radiation therapy (GammaTile) can be placed at the time of tumor removal, delivering immediate radiation to the tumor bed. This eliminates the waiting period before traditional radiation and the burden of multiple radiation sessions.
The tile is absorbed by the body over time.
Dr. Kassam and his team routinely treat complex and previously deemed inoperable cases referred from other centers.
Treatment Options
Surgery
Ranging from minimally invasive endonasal and parafascicular approaches to conscious craniotomy, tailored to tumor location and type.
Radiation Therapy
Including GammaTile (surgically targeted), stereotactic radiosurgery, and conventional radiation.
Chemotherapy
Systemic treatment used for specific tumor types, often in combination with surgery and radiation.
Targeted Therapy & Immunotherapy
Newer treatment modalities that target select tumor types based on molecular profiling.
Treatment plans are developed by a multidisciplinary team and individualized to each patient.
Related Conditions & Innovations
The information on this page is intended for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Every patient's condition is unique. Please consult with Dr. Kassam or your physician to discuss your specific situation.