BRAIN TUMOR

Presented by
Dr Gourav Jatav
Assist Professor
Dept. Of Neurosurgery
INTRODUCTION
A brain tumor is a lump in the brain which is
caused when brain cells divide and grow in an
uncontrolled way. That causes brain cells to
start growing and dividing differently from
healthy cells.
DEFINITION
Brain tumour is an abnormal growth of cells within
the brain, which can be malignant or benign. Any
intracranial tumour created by abnormal and
uncontrolled cell division.
CLASSIFICATION

Primary Secondary
Brain Brain
tumor tumor
 Primary Brain tumor: Primary tumor
originates from cells and structures within the brain

A. Intracerebral tumors
B. Tumor arising from supporting structures

 A] Intracerebral tumors: The most

common primary brain tumors are gliomas.
Theybegin in Glial cells. There aremany types of
Gliomas:
 Astrocytoma

Brain stem glioma

Ependymoma

Oligodendroglioma and
Medullaoblastoma
 B] Tumor arising from supporting structures:
Meningioma, Schwannoma, Craniopharyngioma,
Germ cell tumor of the brain, Pineal region
tumor and Angiomas.
CAUSES AND RISK FACTORS
 Being male
 Race

 Age

 Family history
 Inherited risk

 Occupational exposure: Radiation,

Formaldehyde, Vinyl chloride
OTHER RISK FACTORS

 Radiation to head
 HIV Infection

 Cigarette smoking

 Use of hair
dyes
 Use of cellular
phones
 Head trauma
CLINICAL MANIFESTATIONS
 Elevated intracranial pressure, which translate
clinically into Headache, altered state of
vomiting,
consciousness,
 Dilation of the pupil on the side of the
lesion, papilledema
 Increased intracranial pressure may result
in herniation (displacement) of certain parts of the
brain.
FOCAL NEUROLOGIC DEFICITS
 Parietal area: Impaired speech, inability to write,
memory disturbances, lack of recognition, seizures,
spatial disorders, confusion and depression.
 Frontal lobe: Personality disturbances, behavioural
and emotional changes, impaired judgement, impaired
sense of smell, memory loss, paralysis on one side of
the body, reduced mental capacity, vision loss and
inflammation of the optic nerve.
 Temporal area: Tumors that develop in the temporal
lobe are often asymptomatic but some may cause
memory disturbances, auditory hallucinations.
 Occipital lobe: Visual loss in half of visual field on
the opposite side of tumor, visual hallucinations may
result from a tumor located in the occipital lobe.
 Cerebellar area: Coordination gait and balance
disturbances and Vertigo, weakness or paralysis of
face.
 Brain stem: Behavioural and emotional changes,
difficulty speaking and swallowing, drowsiness, hearing
loss, hemiparesis, muscle weakness on one side of the
face, uncoordinated gait, vision loss, vomiting, cardio-
vascular instability, respiratory depression, coma and
cranial nerve dysfunction.
MANAGEMENT
 Surgery: Surgery is the treatment of choice for
accessible primary brain tumors, when the patient is in
good health. The goal of surgery is to remove as much
of the tumor as possible without damaging nearby
normal brain tissue. Craniotomy, Transsphenoidal
microsurgical removal, Brain-mapping.
 Radiation therapy: Radiation therapy uses high
frequency rays to kill tumor cells. The radiation may
come from x-rays, gamma rays or protons

 Chemotherapy: Agent that commonly work in

patients with high grade gliomas include Procarbazine,
Platinum analogs, ( Cisplatin , Carboplatin) and an
oral medication called Temodar
Supportive care
 Steroids: patients with brain tumours
Most steroids to relieve swelling need the
Dexamethaxone
help may beofused before and afterbrain.
treatment
to reduce cerebral oedema.
 Anti-convulsant medicine- Brain tumours can cause
seizures, patient may take an Anticonvulsant medicine
to prevent or control seizures.
 Shunt- If fluid builds up in the brain, the surgeon may
place a shunt to drain the fluid.
NURSING MANAGEMENT

Decreasing intracranial pressure

 Continually assess patients neurological status

 Monitor and record vital signs and neurological status

 Monitor ICP

 Use strict aseptic technique with ICP monitoring.

 Observe for signs of decreased level of consciousness,
restlessness, visual and other sensory disturbances,
headache, vomiting, seizures and papilledema.
 Ensure proper positioning of the head, elevate head 30
degrees.
 Stool softeners to prevent straining at stool(which
increase intracranial pressure).
Maintaining Normal respiratory pattern

Assess respiratory parameters and ABGs as
monitor indicated.
 Assess the clients level of consciousness
and neurologic status for changes.
 Suction mouth and throat if needed to maintain
the airway.
 Administer oxygen therapy. Hyper
oxygenation prevents increased intracranial
pressure.
Prevent injury

Report any signs increased ICP & Neurologic
of deficits.
 Initiate seizure precautions.

 For patient with visual field deficits , place material

in visual field.
 Maintain client as comfortably as possible
with analgesics and antiemetics as ordered.
Improving nutrition:
 Maintain adequate hydration and nutrition.
 Perform oral hygiene before and after meals
to improve intake.
 Maintain the accurate intake and output records.
Compensating for self-care deficits:
 Maintain range of motion exercise for all joints .

 Supportive nursing care is given depending upon the

patients symptoms and ability to perform activities of
daily living.
CRANIAL NERVES AND THEIR
FUNCTIONS
GOOD TIME WITH YOU