INTRODUCTION DEFINITION INCIDENCE TUMORS GRADES TYPES OF BRAIN TUMOR RISK FACTORS SIGN & SYMPTOMS DIAGNOSTIC EVALUATION MANAGEMENT REHABILITATION

1. Tumor

2. • PRESENTED BY - RITA POKHARIYA
NURSING TUTOR
OBCMS
Brain
Tumo
r

3. CONTENT
INTRODUCTION DEFINITION INCIDENCE
TUMORS
GRADES
TYPES OF
BRAIN TUMOR
RISK FACTORS
SIGN &
SYMPTOMS
DIAGNOSTIC
EVALUATION
MANAGEMENT REHABILITATION

4.  Some brain tumors are noncancerous
(benign), and some brain tumors are
cancerous (malignant).
 Brain tumors can begin in your brain
(primary brain tumors), or cancer can
begin in other parts of your body &
spread to your brain(secondary or
metastatic, brain tumors)

5. Definition
• A brain tumor
is a mass or
growth of
abnormal cells
in your brain.

6. INCIDENCE
• Tumors in India ranges from 5 to 10 per 100,000
population with an increasing trend.
• 40% of all cancers spread to brain.
• Approximately 70% of all brain tumors are benign
• Approximately 30% of all brain tumors are malignant
• Approximately 58% of all brain tumors occur in
females
• Approximately 42% of all brain tumors occur in males

7. 84,170 people will receive a primary brain tumor diagnosis in
2021
An estimated 59,040 will be non-malignant (benign)
An estimated 25,130 will be malignant
The median age at diagnosis for a primary brain tumor is 60 years
The average survival rate for all primary brain tumor patients
is 75.2%
An estimated 18,600 people died from a malignant brain tumor
(brain cancer) in 2021

9. • Grade I. These tumors are slow growing and unlikely to
spread. They can often be cured with surgery.
• Grade II. These tumors are less likely to grow and
spread but are more likely to come back after treatment.
• Grade III. These tumors are more likely to have rapidly
dividing cells but no dead cells. They can grow quickly.
• Grade IV. In a grade IV tumor, cells in the tumor are
actively dividing. In addition, the tumor has both blood
vessel growth and areas of dead tissue. These tumors can
grow and spread quickly.

11. BENIGN
MALIGNANT
PRIMARY
SECONDARY
OTHER

12. 1. Chordomas
 Their most common
locations are the base of
the skull and the lower
portion of the spine.
 Although these tumors
are benign, they may
invade the adjacent bone
and put pressure on
nearby neural tissue.
2. Craniopharyngiomas
• Typically are benign, but are difficult
tumors to remove because of their
location near critical structures deep in
the brain.
• They usually arise from a portion of
the pituitary gland .so nearly all
patients will require some hormone
replacement therapy.
Types of Benign Brain Tumors

13. 4. Glomus jugulare
tumors most frequently are benign
and typically are located just
under the skull base, at the top of
the jugular vein.
3. Gangliocytoma is a rare type of
central nervous system (CNS)
tumor

14. 5. Meningiomas
• They originate from
arachnoid cap cells
6. Pineocytomas is a tumor of
the pineal gland, a small
organ in the brain that
makes melatonin

15. Pituitary adenomas
• Most pituitary adenomas are slow-
growing and benign, which means they
are not cancer and do not spread to
other parts of the body.
• However, as they grow big they can put
pressure on nearby structures, such as
the nerves that connect the eyes to the
brain, and cause symptoms.
Schwannomas
• grows from cells called
Schwann cells.
• Schwann cells protect and
support the nerve cells of the
nervous system.

16. Types of Malignant Brain Tumors
Gliomas
• Glioma is a type of
tumor that occurs
in the brain and
spinal cord.
• Gliomas begin in
the gluey
supportive cells
(glial cells) that
surround nerve
cells and help them
function. :
Astrocytomas
• Astrocytoma is a type of cancer that can
occur in the brain or spinal cord.
• It begins in cells called astrocytes that
support nerve cells.

17. Ependymomas
• Ependymoma is a
type of tumor that
can form in the
brain or spinal cord.

18. Glioblastoma multiforme (GBM)
• Glioblastoma (GBM), is a fast-
growing and aggressive brain tumor.
• It invades the nearby brain tissue, but
generally does not spread to distant
organs.
• .

19. •Medulloblastomas
Usually arise in
the cerebellum, most
frequently in children.
.
• Oligodendrogliomas Oligodendroglioma is a
tumor that can occur in the brain or spinal cord.
• Oligodendroglioma forms from
oligodendrocytes — cells in the brain and spinal
cord that produce a substance that protects nerve
cells.

20. OTHER TYPES OF BRAIN TUMORS
• Hemangioblastomas
• Hemangioblastomas are
benign brain tumors that
most often arise in the
cerebellum or brainstem.
Symptomatic hemangiobla
stomas generally require
surgical removal.
• Rhabdoid tumors
• Rhabdoid tumor is a type
of tumor that is made up of many
large cells.
• Some rhabdoid tumors can grow in
the brain, and these are called
atypical teratoid rhabdoid
tumors (ATRT).

21. •
Ionizing radiation
Family history
Age
Home and work exposure
Exposure to infection, viruses and allergens
Head injury
Seizures
Chemical exposure

22. PATHOPHYSIOLOGY
DUE TO ETIOLOGY FACTORS
IRRITATION & DAMAGE TO
CELL STRUCTURE
CHANGE
IN CELL MORPHOLOGY OCCUR
INACTIVATION OF TUMOR SUPRESSOR GENE &
ACTIVATION
OF ONCOGENE

23. UNCONTROLLED CELL
DIVISION
HYPERPLASIA OF BRAIN CELL
BRAIN TUMOR

25. • Headaches
• Vomiting
• Blurred vision or
double vision
• Confusion
• Seizures
• Weakness of a limb or
part of the face
• A change in mental
functioning
• Lumsiness
• Memory loss
• Confusion
• Difficulty writing or
reading
• Changes in the ability to
hear, taste, or smell

26. Drowsiness and loss of consciousness
Difficulty swallowing
Dizziness or vertigo
Eye problems, such as drooping eyelids and unequal
pupils
Hand tremors
Loss of balance
Loss of bladder or bowel control
Numbness or tingling on one side of the body
Trouble speaking or understanding what others are saying
Changes in mood, personality, emotions, and behaviour
Difficulty walking
Muscle weakness in the face, arm, or leg

27. CT SCAN
MRI
BIOPSIES
MRS
POSITRON EMISSION
TOMOGRAPHY
HISTORY COLLECTION &
NEUROLOGICAL
EXAMINATION
DIAGNOSTIC
EVALUATION

28. • Computed tomography (CT or CAT scan) and magnetic
resonance imaging (MRI). Other MRI sequences can help the
surgeon plan the resection of the tumor based on the location of
the normal nerve pathways of the brain.
•Intraoperative MRI also is used during surgery to guide
tissue biopsies and tumor removal.
•Magnetic resonance spectroscopy (MRS) is used to
examine the tumor's chemical profile and determine
the nature of the lesions seen on the MRI.
• Positron emission tomography (pet scan) can help
detect recurring brain tumors.

30. MEDICAL MANAGEMENT
• ANTIEPILEPTIC
• CORTICOSTEROIDS
• ANTIANXIETY
• ANTIHYPERTENSIVE
• ANALGESIC

31. Radiation Therapy
• Radiation therapy uses high-energy X-
rays to kill cancer cells and abnormal
brain cells and to shrink tumors..

32. CHEMOTHERAPY
Treatment that uses drugs to stop the
growth of cancer cells, either by killing
the cells or by stopping them from
dividing.
Chemotherapy may be given by mouth,
injection, or infusion, or on the skin,
depending on the type and stage of the
cancer being treated..

33. Visualase
This involves placing a tiny catheter within the lesion, possibly
completing a biopsy, then using laser to thermally ablate the
lesion. This technique is only more recently used in brain tumor
treatments, therefore the long term efficacy has not been
established.

34. • Targeted therapy is a mode of treatment that exploits the
unique characteristics of cancer cells to attack them.
Targeted therapies are medications that inhibit activities
cancer cells rely on to survive.
• One type of targeted therapy inhibits a tumor from
developing new blood vessels that it needs to grow.
Targeted
Therapy

35. SURGICAL MANAGEMENT
CRANIOTOMY
BURR HOLE
CRANIECTOMY
CRANIOPLASTY
STEREOTAXIS
SHUNT PROCEDURE

36. CRANIOTOMY

38. • A craniectomy is a surgery done to remove a
part of your skull in order to relieve pressure in
that area when your brain swells.

39. •Cranioplasty is a surgical operation on the repairing of
cranial defects caused by previous injuries or operations, such as
decompressive craniectomy.
•It is performed by filling the defective area with a range of
materials, usually a bone piece from the patient or a synthetic
material.

40. • A shunt is a hollow tube
surgically placed in the
brain (or occasionally
in the spine) to help
drain cerebrospinal fluid

41. NURSING MANAGEMENT
• PREOPERATIVE CARE
• INSTRUCT PT & FAMILY ABOUT THE NECESSITY &
IMPORTANCE OF DIAGNOSTIC TEST TO DETERMINE
LOCATION OF THE TUMOR.
• MONITOR & RECORD VITAL SIGN.
• ELEVATE HEAD OF BED 30
• ADMINISTER ALL DOSE OF STEROIDS.
• SURGERY PERFORMED
• ASSESSS LEVEL OF ANXIETY,LEVEL OF PAIN
• MONITOR SEIZURE

42. POSTOPERATIVE CARE
• MONITOR & RECORD VITAL SIGN
• PT MAY BE LUCID DURING FIRST
24HRS
• MAINTAIN SKIN INTEGIRITY.
• COUGH & DEEP BREATH EVERY 2HRS.
• CONTINUOUSLY TALK TO THE
PATIENT WHILE PROVIDING CARE
• MAINTAIN BODY TEMP.
• MAINTAIN & RECORD INPUT &
OUTPUT CHART

44. •
Rehabilitation can be a very
important part of the
treatment plan. The goals of
rehabilitation depend on
your needs and how the
tumor has affected your
ability to carry out daily
activities.

45. Several types of therapists
can help:
• Physical Therapists
• Speech Therapists
• Occupational Therapists
• Physical Medicine
Specialist
•Children with brain tumors
sometimes have tutors in the
hospital or at home.
• Children who have
problems learning or
remembering what they leam
may need tutors or special
classes when they retum to
school.

46. • Physical therapists: Brain tumors and their treatment may
cause paralysis. They may also cause weakness and problems
with balance. Physical therapists help people regain strength
and balance
• Speech therapists: Speech therapists help people who have
trouble speaking, expressing thoughts, or swallowing.
• Occupational therapists: Occupational therapists help people
learn to manage activities of daily living, such as eating, using
the toilet, bathing, and dressing.
• Physical medicine specialists: Medical doctors with special
training help people with brain tumors stay as active as
possible. They can help people recover lost abilities and return
to daily activities.

47. Complication
Increased ICP
Brain herniation
Death
Neurological deficit

48. Conclusion
• It is a growth of abnormal cells in your brain. Tumors in india ranges from 5 to 10 per 100,000
population with an increasing trend.
• It is devided into four grade grade i. These tumors are slow growing.Grade iitumors are less
likely to grow and spread.Grade iii. These tumors are more likely to have rapidly dividing cells
but no dead cells.Grade iv. Cells in the tumor are actively dividing.
• Brain tumor risk factors are ionizing radiation ,family history age,home and work
exposure ,exposure to infection, viruses and allergens ,head injury ,seizures ,chemical exposure
• There are many types of tumors that are melignant ,benign tumor, prmary ,secondary tumor &
other
• Brain tumor sign & symptoms are headaches vomiting blurred vision or double vision confusion
,seizures,weakness of a limb or part of the face
• Diagnostic evaluation for brain tumor ct scan ,mri, biopsies ,mrs,positron emission
tomography,history collection & neurological examination
• There treatment are craniotomy, craniotomy burr hole,craniectomy,cranioplasty,stereotaxis,shunt
procedure
• Basically used radiotherapy & chemotherapy inn tumor

49. Reference

50. • Book refrence
• Suresh k sharma ;”manual of medical surgical nursing” ;published by wolters kluwer
(India) Pvt.Ltd,new Delhi;edition 3rd ;page no 740-745
• Cecy Correia; ‘‘medical surgical nursing ’’; published by jaypee publisher ; edition1st
;page number 342-346
• Linda S.Williams,Paula D.Hopper:;”Medical surgical nursing” ;Printed in the united
states of America ;Edition 4th ; page number 1152-1156
• Brunner & Sidhart’s ; ‘‘The text book of medical surgical nursing II’’; published by
jaypee publisher ; edition13th ;page number 1225-1230
•
• Net reference
• www.myoclinical.com
• www.healthline.com
• www.medicalnewstoday.com
• https://www.cancer.net/cancer-types/brain-tumor/statistics
• https://seer.cancer.gov/statfacts/html/brain.html

51. • Enhanced imaging tests. New techniques for imaging scans are being researched.
These may help doctors better track how well treatment is working and watch for
possible tumor recurrence or growth.
• Immunotherapy. Immunotherapy, also called biological response modifier
(BRM) therapy, is designed to boost the body's natural defenses to fight the tumor. It
uses materials either made by the body or in a laboratory to improve, target, or
restore immune system function. Different methods are being studied for brain
tumors, such as the use of dendritic cells or the use of vaccines aimed against a
specific molecule on the surface of the tumor cells. Several methods are currently
being tested in clinical trials.
• Targeted therapy. As outlined in Types of Treatment, this type of treatment targets
faulty genes or proteins that contribute to a tumor’s growth and development.
Research continues on the use of therapies for brain tumors that target the different
ways a tumor grows, how a tumor spreads, and how tumor cells die.
• Blood-brain barrier disruption. This technique temporarily disrupts the brain’s
natural protective barrier in order to allow chemotherapy to more easily enter the
brain from the bloodstream.
• Gene therapy. This type of therapy seeks to replace or repair abnormal genes that
are causing or helping tumor growth.
• Palliative care/supportive care. Clinical trials are underway to find better ways of
reducing symptoms and side effects of current brain tumor treatments to improve
comfort and quality of life for patients.