What is Insular Glioma? Symptoms and Current Treatment Methods
Our brain possesses a magnificent mechanism. Deep within this complex structure lies a hidden region we call the “Insula.” You cannot see this region from the outside. The insula hides between the folds of the frontal and temporal lobes. This center manages our emotions, heart rhythm, and even our ability to speak. However, sometimes tumors called insular gliomas emerge in this critical point.
In this article, we will explain what insular glioma is and the solutions modern medicine offers. You will learn about the treatment processes we apply with our team in full transparency.
What Exactly Is Insular Glioma?
Insular glioma originates from the “glia,” which are the brain’s support cells. When these cells lose control, they become tumors and settle in the insula region. We doctors consider these tumors to be one of the most challenging groups surgically. This is because the tumor neighbors the brain’s busiest main pathways.
We generally encounter these masses in two different characters:
- Low-Grade Gliomas: They grow slowly but progress insidiously.
- High-Grade Gliomas: They show a faster and more aggressive spread.
The tumor is not easily separable from its shell like an orange. On the contrary, it grows by infiltrating into the brain tissue. We usually diagnose this in young and middle-aged individuals. Genetic features we detect in tests, such as the IDH mutation, increase our treatment success. These genetic structures allow our patients to respond better to treatment.
What Signals Does Your Body Give You?
As the tumor grows, it exerts pressure on its location. As a result of this pressure, your body sends you some warnings. Our patients usually apply to us with complaints of having seizures.
The Most Common Symptoms We See
1. Seizures (Crises) The most distinct harbinger of the disease is seizures. However, not every seizure occurs in the form of convulsions. Sometimes you smell a strange odor. Sometimes you get a feeling in your stomach that you cannot describe (visceral aura). Sometimes you suddenly experience “déjà vu” (the feeling of having lived through something before). These symptoms indicate an electrical storm in the insula region.
2. Speech Difficulties If the tumor is on the dominant side of the brain (usually the left), words come out of your mouth with difficulty. You struggle to find the right word. You may have trouble understanding what the person in front of you is saying.
3. Clumsiness in Movement You feel a slight weakness in your arm or leg. You might drop the cup in your hand or struggle while buttoning your shirt. The tumor creates this picture when it affects the movement pathways.
4. Sensory Disturbances Tingling begins in one half of your body. Sometimes you do not feel that area at all. This situation indicates that the sensory nerves are under pressure.
How Do We Diagnose?
When you or a relative has a seizure, you go to the emergency room. Initial examinations point to a problem. However, we need detailed images to make a definitive diagnosis. When we suspect a [Brain Tumor], we follow this path:
- Contrast Brain MRI: We see the exact location and boundaries of the tumor with this method. The MRI device shows us the mass inside the insula clearly.
- DTI Imaging (Tractography): We map the invisible nerve pathways inside the brain with this technology. Thus, we understand how close the tumor is to the movement center.
- Functional MRI: You perform some commands while inside the device. We then determine the exact location of your speech center.
Thanks to these tests, we create a roadmap in our minds before the surgery.
How Do We Manage Treatment?
Our strongest weapon in insular glioma treatment is surgery. Reaching this region requires great precision for us brain surgeons. Because the insula is hidden in the depths of the brain and is surrounded by vital vessels.
1. Our Surgical Approach (Microsurgery)
Our main goal in surgery is this: To remove the entire tumor or as much of it as possible without harming you. We call this “Maximum Safe Resection.” We perform these challenging surgeries safely by using the power of technology.
The Methods We Use:
- Awake Brain Surgery: We especially prefer this method. We do not put you to sleep during the surgery. We chat with you while clearing the tumor. We ask you to raise your arm or name pictures. Thus, when we approach sensitive areas, we notice this immediately and protect that area.
- Neuronavigation: This system guides us inside the brain. Just like a GPS, we track exactly where we are in the tumor instantly.
- Neuromonitoring: We monitor the electrical current of the nerves with devices throughout the surgery.
Scientific data tells us this: The more we clear the tumor, the longer and higher quality life you live. Additionally, your post-surgical seizures are largely brought under control.
2. Post-Operative Additional Treatments
Our work does not end after surgery. Pathologists examine the piece we removed. They map out the genetics of the tumor. Based on this result, our oncologist colleagues step in.
- Radiotherapy: We aim to destroy remaining microscopic cells with rays.
- Chemotherapy: We try to prevent the tumor from recurring by using smart drugs (such as Temozolomide).
Our team prepares a treatment plan specific to you according to the tumor type.
What You Wonder About (Frequently Asked Questions)
We have answered the questions our patients ask us most frequently in the clinic below.
No, you will not feel pain. Brain tissue does not have its own pain sensation. We only numb your skin. You talk to us during awake brain surgery, but you do not feel pain.
There is always a risk, but modern technology reduces this risk greatly. We protect your movement pathways instantly with neuromonitoring and awake surgery. Even if you experience temporary weakness, these usually correct with physical therapy.
In low-grade gliomas, we stop the disease for many long years with successful surgery. In medicine, we find the term “keeping under control” more accurate than “cure.” We aim for you to live a healthy life with regular follow-ups.
When we remove the tumor mass, the focus irritating the brain also disappears. In the vast majority of our patients, seizures stop completely after surgery. In some patients, we provide much easier control with medication.
We usually discharge our patients 3-4 days after surgery. After a resting period of a few weeks at your home, you return to your daily life.
Final Words and Doctor’s Advice
Receiving an insular glioma diagnosis can frighten you. However, you are not alone on this path. We brain surgeons now achieve much more successful results thanks to developing technology and [Awake Brain Surgery] techniques. Early diagnosis directly affects the success of the treatment. If you have persistent seizures or speech disorders, consult a specialist without wasting time. You can regain your health with correct planning and an experienced team.
We wish you healthy and peaceful days.
