NEOPLASMS OF THE

CENTRAL NERVOUS
SYSTEM(CNS)
 PREVENTION & SCREENING

NO DEFINITE PREVENTION OR
BRA
IN & SCREENING PROGRAMS
CNS
CAN
CER
 DETECTION

EARLY DETECTION IS A POSITIVE

PROGNOSTIC FACTOR
BRA
IN &
CNS
CAN
CER
 DETECTION
WHY?

EARLY AWARENESS OF SIGNS AND

BRA
IN & SYMPTOMS LEAD TO…
CNS
CAN 1.EARLY DIAGNOSIS
CER
2.FEWER NEUROLOGIC SYMPTOMS
3.BETTER OUTCOMES
BRAIN TUMORS
CLASSIFICATION OF BRAIN
TUMORS
 4 MOST COMMON PRIMARY BRAIN
TUMORS
1. GLIOMA
CAN
CER 2. MENINGIOMA
OF
THE
CNS
3. NERVE SHEATH TUMORS

4. PITUITARY
 GLIOMA TYPES
1. ASTROCYTOMA
CAN
CER 2. OLIGODENDROGLIOMA
OF
THE
CNS
3. MIXED GLIOMA

4. EPENDYMOMA
 MOST COMMON SITES OF ORIGIN-
GLIOMA

1.Cerebral hemispheres- 65%

CAN frontal, parietal, temporal & occipital lobes
CER
2. Brain stem- 4%
OF
THE 3. Cerebellar - 3%
CNS 4. Ventricular – 2%
 1. ASTROCYTOMAS
DIVISIONS ACCORDING TO WHO

CAN
CER GRADE 1 – PILOCYTIC ASTROCYTOMA
OF GRADE 11 – ASTROCYTOMA
THE
CNS
GRADE 111 – ANAPLASTIC
ASTROCYTOMA
GRADE IV – GLIOBLASTOMA
MULTIFORME (GBM)
 2. OLIGODENDROGLIOMA

- 10% OF GLIOMAS
CAN
CER
OF - MOST OFTEN LOW GRADE WTH SOME
THE MALIGNANT FEATURES
CNS
 3. EPENDYMOMA

- 6% OF GLIOMAS

CAN
CER - DEVELOP IN THE WALLS OF
OF VENTRICLES
THE
CNS - SLOW GROWING

-OUTCOME IMPROVES WITH

AGGRESSIVE SURGICAL RESECTION
 4. MENINGIOMA

-30% OF PRIMARY TUMORS

CAN
CER
OF - ORIGINATES FROM THE ARACHNOID
THE COVERING OF THE BRAIN
CNS
- 90% ARE BENIGN & 10% ARE
AGGRESSIVE
 5. SCHWANNOMAS
- 8% OF PRIMARY TUMORS

CAN
- MOST COMMON SITE OF ORIGIN: IS
CER
OF THE 8TH NERVE (ACOUSTIC NEUROMA)
THE - DEVELOP FROM CANIAL NERVE SHEATH
CNS
- SLOW GROWING

- CURABLE WITH SURGERY

 6. PITUITARY TUMORS

- 7% OF PRIMARY TUMORS

CAN
CER - ADENOMA IS THE MOST COMMON
OF TYPE OF PITUITARY TUMOR
THE
CNS - SLOW GROWING

- RESPOND WELL WITH SURGERY,

MEDICAL OR RADIOTHERAPEUTIC
 SIGNS AND SYMPTOMS OF
BRAIN AND
CENTRAL NERVOUS SYSTEM
(CNS) TUMORS
 GENERAL SYMPTOMS
 INCREASED ICP
 HEADACHE- “+” IN 50% OF PTS
 NAUSEA/VOMITING
 PAPILLEDEMA
CHANGES IN MENTAL STATUS
 MENTAL SLOWNESS
INABILITY TO CONCENTRATE
-SEIZURES
DIAGNOSIS OF BRAIN TUMORS
1.PHYSICAL EXAMINATION

2.BLOOD TESTS

3.COMPUTED TOMOGRAPHY-CT SCAN

4.MRI WITH CONTRAST

 DIAGNOSIS
5.MAGNETIC RESONANCE
ANGIOGRAPHY

6.SPECTROSCOPY

7.POSITRON EMISSION TOMOGRAPHY

(PET SCAN)

8.FUNCTIONAL MRI (fMRI)

 MEDICAL TREATMENT MODALITIES
1. SURGERY
NURSING CONSIDERATIONS
1. Obtain client history
2. Perform physical examination
3. Review and obtain consent form with the client
4. Discuss pre-operative routines

5. Discuss intraoperative therapies i.e.

chemotherapy, local radiation therapy, etc.
 MEDICAL TREATMENT MODALITIES
1. SURGERY
NURSING CONSIDERATIONS
6. Provide postoperative and discharge plans

7. Discuss rehabilitation needs, home care and

scheduling follow ups

8. It is pertinent that family members are

included during client information and
management of disease.
 MEDICAL TREATMENT MODALITIES
2. RADIATION THERAPY
NURSING CONSIDERATIONS
1. Use of RT must be explained before surgery

2. Risks and benefits are discussed

3. Client is informed about possible

complications and what symptoms should be
reported immediately
MEDICAL TREATMENT MODALITIES
2. RADIATION THERAPY
NURSING CONSIDERATIONS

4. Additional side effects of therapy must be

provided such as alopecia, changes in saliva an
taste alterations
MEDICAL TREATMENT MODALITIES
3. CHEMOTHERAPY
NURSING CONSIDERATIONS

1. Inform client that nausea and vomiting are

common side effects in the beginning of therapy
MEDICAL TREATMENT MODALITIES
3. CHEMOTHERAPY
NURSING CONSIDERATIONS

2. Have emergency numbers ready for office

hours and after hours if needed
 OTHER TREATMENT MODALITIES
1. GENE THERAPY
NURSING CONSIDERATIONS

1. OBTAIN CONSENT FROM CLIENT

2. WITHDRAWAL FROM THE THERAPY

WILL NOT CARRY ANY CONSEQUENCES
ON THE CLIENT IF HE EXPERIENCES
SIDE EFFECTS
DISEASE-RELATED
COMPLICATIONS
AND
TREATMENT
 MOST COMMON COMPLICATIONS OF
BRAIN TUMORS

1. INCREASED ICP
2. SEIZURES
3.MENTAL STATUS CHANGES
4.FOCAL NEUROLOGIC SIGNS
5.DVT-DEEP VEIN THROMBOSIS
6. PE-PULMONARY EMBOLISM
 MOST COMMON COMPLICATIONS OF
BRAIN TUMOR TREATMENTS

1. INTRACRANIAL HEMORRHAGE
2. INFECTION
3.NECROSIS
4.STEROID MYOPATHY
5.IMMUNOSUPPRESSION
6. COGNITIVE SEQUALE
SPINAL CORD TUMORS
 EPIDEMIOLOGY
ABOUT FACTS…..

4% of central nervous system tumors

CNS
CAN Benign or malignant
CER
 PHYSIOLOGY

1.EXTRAMEDULLARY
a. extradural-most common spinal
CNS cord tumors
CAN b. intradural – generally benign
CER

2.INTRAMEDULLARY - glial
 DETECTION

EARLY DETECTION BEFORE

NEUROLOGIC DECLINE TAKES
PLACE
CNS
CAN
CER
 DETECTION

CNS EARLY DETECTION IS KEY

CAN
CER
TO INCREASED SURVIVAL
AND QUALITY OF LIFE
Risk factors
Hereditary
Exposure to electromagnetic radiation
Types
Extramedullary
◦ Outside the cord and outside the dura (extradural)
◦ Outside the cord and inside the dura (intradural)
Intramedullary
◦ Inside the cord
S/sx
Pain
Weakness
Numbness
Bowel and bladder dysfunction
Diagnostic test
MRI
MEDICAL TREATMENT MODALITIES
1. SURGERY
NURSING CONSIDERATIONS

GOAL OF SURGERY IS PRESERVATION OF

NEUROLOGIC FUNCTION
2. Radiation therapy