Steroid Avoidance, Dexamethasone, and RAGE Inhibition for Perioperative Cerebral Edema Management in High-Grade Gliomas

Inclusion Criteria: Age ≥18 years at the time of screening * Newly diagnosed supratentorial tumor with imaging characteristics consistent with high-grade glioma * Candidate for craniotomy with planned resection of more than 50% of the contrast-enhancing tumor * Midline shift ≤10 mm on preoperative imaging * Limited pre-enrollment corticosteroid exposure (≤10 mg dexamethasone total and no chronic steroid use within 30 days) * Karnofsky Performance Status ≥60 * Adequate organ function to undergo surgery and postoperative care as determined by the investigator * Ability to provide informed consent and comply with study procedures * Agreement to use effective contraception, when applicable Exclusion Criteria: * Participants meeting any of the following will be excluded: * Imaging or clinical features highly suggestive of primary CNS lymphoma or metastatic disease * Posterior fossa tumors or lesions associated with high risk of brainstem compression * Leptomeningeal or widely disseminated disease * Clinical conditions requiring immediate corticosteroid therapy * Prior exposure to high-dose corticosteroids (\>10 mg dexamethasone) or chronic steroid use within 30 days * Active systemic illness that increases surgical risk, including uncontrolled infection, coagulopathy, or severe cardiopulmonary disease * Pregnancy or breastfeeding * Known immunodeficiency or chronic infection requiring immunosuppressive therapy * Use of investigational agents within 30 days o…