Blood Brain Barrier Differences in Patients with Brain Tumors Undergoing Surgery

Inclusion Criteria: * Age \>= 18 years * Clinical and radiographic evidence suggesting CNS malignancy * Suspected newly diagnosed, local, or intracranial recurrence of primary brain tumor OR previously untreated or treated brain metastasis * Willing to undergo a neurosurgical resection of CNS lesion at Mayo Clinic Rochester * Able to have magnetic resonance imaging (MRI) imaging with gadolinium contrast (e.g. no cardiac pacemaker, defibrillator, renal failure) * Females of childbearing potential must have a negative pregnancy test done =\< 14 days prior to registration * Provide written informed consent * Willing to provide tissue and blood samples for research purposes * Patients having a study-specific surgical planning MRI only: Creatinine (estimated glomerular filtration rate \[eGFR\] \>= 30) (obtained =\< 30 days prior to registration) Exclusion Criteria: * Vulnerable populations: pregnant women, prisoners, mentally handicapped * Unable to undergo a biopsy of CNS lesion * Documented drug allergy to cefazolin or levetiracetam, or other contraindication to use these drugs in the pre-operative setting (e.g., patient is already on another anti-seizure medication which precludes the clinical indication for pre-operative levetiracetam) * Patients who are unable to swallow tablets if study drug is administered by mouth * Patients who are at risk for impaired absorption of oral medication if study drug is administered by mouth; Note: This includes but not limited to, refractory vomiting, gastric resection/bypass, and duodenal/jejunal resection * Pregnant or nursing women; Note: Pregnant women are excluded from this study because of the potential for teratogenic or abortifacient effects with chemotherapy; there is also a potential risk for adverse events (AEs) in nursing infants secondary to treatment of the mother with these drugs, so breastfeeding should be discontinued for the duration of the study