3. DEFINITION
Brain tumor is a localized intra cranial lesion that
occupies a space within the skull .Tumor usually
grows as spherical mass but they can grow diffusely
and infiltrate tissue.
4. EPIDEMIOLOGY
In India incidence rate is 3 -4 per 100000 persons per year
The brain is a frequent site for metastasis from other sites
.The 5 years survival rate of primary brain tumours are
approximately 36%
Male have slightly higher incidence of brain tumour.
Commonly seen in middle aged persons
5. RELATED ANATOMY AND
PHYSIOLOGY
Brain
It is the largest organ of the body it coordinates
most body activities
The brain contains in a skull and weight 1300-
1400gm
Brain is covered by meninges, outer duramater
,middle aracnoidmater & inner piamater
6. VENTRICLES OF BRAIN
There are certain cavities in the brain called as ventricles
These Ventricles are filled with csf
There are 4 ventricles of the brain
Two lateral ventricles in two hemispheres of the brain,3rd
lies between hypothalamus and thalamus ,4th between
brain stem and cerebellum.
7. PARTS OF THE BRAIN
Cerebrum Cerebellum Brainstem Diencephalon
Right
cerebral
hemispher
e
Left
cerebral
hemispher
e
• Medulla
• Pons
• Mid brain
• Thalamus
• Hypothalamus
• Epithalamus and
pineal gland
8.
9. TYPES
Brain tumor can occur any site of the brain .
Primary brain tumor originated from the cell and
structures within the brain.
Secondary brain tumor develop from structures
outside the brain.
10. TYPE TISSU OF
ORIGIN
CHARACTER-
ISTICS
Gilomas
• Astrocytoma
Support tissue,gilal cell
and astrocytes
Low to Moderate grade
malignancy
Glioblastoma Primitive stem cell • Highly malignant and
invasive
Oligodendroma Oligodendrocytes Beinign
Epiendymoma Epiendymal epithelium Benign to highly
malignant
Medulloblastoma Primitive neuroticdermal
cell
Highly malignant and
invasive
11. TYPE TISSUE OF
ORIGIN
CHARACTERI
STICS
Meningioma Meninges Benign/Malignant
Acoustics neuroma Cells that form myelin
sheath around nervous
system commonly affect
cranial nerve viii
• Many grow both sides
of the brain
• Benign/low grade
malignant
Hemangioblastoma Blood vessels of brain Rare & Benign
Primary central nervous
system lymphoma
Lymphocytes Increased incidence in
transplant recipients and AIDS
Pituitary adenoma Pituitary gland Benign
Metastatic tumor Lungs ,Tumor Malignant
12. ETIOLOGY AND RISK FACTORS
Often unknown
Familial tendency
Immuno Immuno suppression
Environmental risk factors
Injury
Viruses
Ionizing radiation
Errors in fetal development
16. CLINICAL MANIFESTATIONS
The clinical manifestations of brain tumor depends
mainly on their location and size.
CEREBRAL HEMISPHERES
Frontal lobe (Unilateral) - uni lateral
hemiplegia,seizures,memory deficit,personality
and judgement changes visual disturbances.
17. FRONTAL LOBE (BILATERAL) : Symptoms associated with
unilateral frontal lobe tumor
Occipital lobe : vission disturbances and seizures
Temporal lobe : few symptoms,seizures,dysphagia
Subcortical tumors- Hemiplegia ,other symptoms may
depend on the area of infiltration
Metastatic tumors – headache,nausea,vomiting,increased
ICP
18. Thalamus tumors - headache,nausea,vision
disturbances,papilledema and hystagmns occur from increased
Fourth ventricle and cerebellar tumors- headache,nausea
,papilledema from increased ICP
, diabetes incipidus may occur
Cerebellopontine tumors – tinnitus &vertigo,deafness
Brainstem tumors- headache on
awakening,drowsiness,vomiting,facial muscle weakness,hearing
loss,dysphagia,visual changes
25. NURSING ASSESSMENT
Neurological assessment should be done,patient’s
motor abilities &sensory perception,integrated
function &balance should be assessed
Coping abilities of the patient,caregivers &family
also be assessed
All initial baselines data should be collected
26. Question about the medical history,intellectual
abilities and educational level and his of nervous
system infection and trauma should be assessed
Presence of seizures,syncope,nausea and
vomiting,headache should be determine.
27. NURSING DIAGNOSIS
Risk for ineffective cerebral tissue perfusion related to cerebral
edema
Acute pain related to cerebral edema and increased ICP
Anxiety related to diagnosis and treatment
Potential complications,seizures related to tumor and failure
Increased ICP related to tumor and failure of the normal
compensatory mechanism.
28. PLANNING
Maintain normal ICP
Minimize neurologic functioning
Achieve control of pain and discomfort
Be aware of long term implication with
respect to prognosis and cognitive
&physical functioning.
29. NURSING INTERVENTION:
1. General measures-
Identification of the behavioral changes
Protecting the patient from self harm
Use realoty orientation for the confused patient
Seizure precautions
Alteration of mobility should be managed
Establishing a common communication system
Healthly nutritional status maintenance
30. PRE OPARATIVE NURSING CARE:
Baseline data should be collected
Treatment procedures explained fully
If hair is shaved ,give it to the patient and family
An antiseptic shampoo may be ordered at the night
before surgery
Family is prepared for appearance of patient after
surgery
31. POST OPARATIVE NURSING CARE :
Perform monitoring
Promote mobility
Promote decreased intracranial pressure
Protect safety of patients
Promote electrolyte balance
Promote comfort
32. EVALUATIONS
Achieve control of pain,vomiting and other
discomfort
Maintain ICP within normal limit
Demonstrate normal neurological function
Accept long term the long term consequences
of the tumor and its treatment.
