Glioma & Glioblastoma (GBM)

Advanced Surgical Management • Connectomics-Guided Planning • Multidisciplinary Care in New York City

Overview

Gliomas are primary brain tumors that arise from the brain’s supporting glial cells. They range from lower-grade tumors (Grade II and III) to glioblastoma (GBM), the most aggressive form (Grade IV). These tumors often grow within or near critical brain networks responsible for movement, language, memory, and executive function—making safe, effective surgery highly dependent on precise mapping and individualized planning.

As a neurosurgical oncologist at Lenox Hill Hospital and Director of Northwell Health’s Brain & Spine Metastasis Program, Dr. Randy S. D’Amico provides advanced surgical care for patients with newly diagnosed, progressive, or recurrent glioma and GBM. His practice focuses on maximizing tumor removal while preserving the networks that support speech, cognition, and identity.

Types of Gliomas Treated

  • Glioblastoma (GBM)

  • Anaplastic glioma (Grade III)

  • Diffuse low-grade glioma (Grade II)

  • IDH-mutant gliomas

  • IDH-wildtype gliomas

  • Recurrent or previously treated gliomas

  • Tumors involving eloquent cortex (motor, language, SMA)

  • Gliomas causing seizures or cognitive decline

Each tumor type requires a customized strategy informed by imaging, functional mapping, and multidisciplinary input.

Symptoms

Glioma symptoms vary depending on tumor location and growth pattern:

  • Headaches or nausea

  • Seizures

  • Speech or language changes

  • Weakness or coordination problems

  • Cognitive slowing or personality change

  • Vision problems

  • Difficulty with planning, multitasking, or executive function

Any new neurological symptom warrants prompt evaluation.

Diagnosis & Evaluation

Evaluation typically includes:

  • MRI with advanced tumor protocols

  • Functional MRI (fMRI) for language and motor network assessment

  • DTI / connectomics analysis to map white-matter networks

  • Neurocognitive assessment, especially for tumors near language or executive networks

  • Tumor molecular profiling (IDH status, MGMT methylation, other biomarkers)

These elements together help determine whether surgery, radiation, chemotherapy, or clinical trials are most appropriate.

Surgical Approach

Connectomics-Guided Planning

Dr. D’Amico uses individualized brain network mapping to understand how each patient’s tumor interacts with functional circuits. This allows for:

  • Identification of safe corridors for tumor removal

  • Preservation of speech, motor, and cognitive networks

  • Minimization of postoperative deficits

  • Improved long-term quality of life

Awake Brain Surgery

For tumors near language or motor areas, Dr. D’Amico performs awake craniotomy with intraoperative mapping, allowing real-time testing of:

  • Speech

  • Movement

  • Sensation

  • Cognition and executive tasks

This is often the safest way to maximize tumor removal while preserving function.

Minimally Invasive Approaches

Select cases may be approached using:

  • Keyhole craniotomies

  • Tubular or endoscopic-assisted corridors

  • Exoscopic visualization

  • Laser Insterstitial Thermal Therapy (LITT)

These techniques aim to reduce recovery time and minimize disruption to healthy tissue.

Treatment Beyond Surgery

Dr. D’Amico works closely with neuro-oncology and radiation oncology to coordinate:

  • Radiation therapy (IMRT, proton therapy, brachytherapy, GammaTile in select cases)

  • Chemotherapy and targeted systemic treatments

  • Clinical trials for IDH-mutant gliomas, recurrent GBM, and innovative therapeutics

  • Rehabilitation and cognitive recovery strategies

This multidisciplinary approach ensures that patients receive comprehensive, personalized care.

Second Opinions

Many patients seek Dr. D’Amico for:

  • Lesions labeled “inoperable”

  • Tumors in eloquent areas

  • Recurrent glioma or GBM after prior treatment

  • Evaluation for advanced mapping techniques

  • Guidance on surgery vs. radiation vs. clinical trials

Second opinions are often available quickly, especially for new or symptomatic diagnoses.

Serving Patients in New York City & the Tri-State Area

Care is provided at Lenox Hill Hospital, located on the Upper East Side of Manhattan (100 E 77th St, New York, NY 10075), with convenient access for patients from:

  • Manhattan

  • Brooklyn

  • Queens

  • The Bronx

  • Long Island

  • Westchester

  • Northern New Jersey

Next Steps

If you or a loved one has been diagnosed with glioma or glioblastoma:

  • Request a Consultation

  • Seek a Second Opinion

  • Refer a Patient

For a comprehensive overview of related conditions, return to the Conditions Treated page.