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ClASS PRESENTATION ON
BRAIN TUMOR
PRESENTED BY – MANIDIPA BAKSHI
ROLL NO – 19
B.SC NURSING 3RD YEAR
INTRODUCTION
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.
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
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
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.
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
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.
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
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
ETIOLOGY AND RISK FACTORS
 Often unknown
 Familial tendency
 Immuno Immuno suppression
 Environmental risk factors
 Injury
 Viruses
 Ionizing radiation
 Errors in fetal development
PATHOPHYSIOLOGY
Risk factors
Normal brain tissue compressed
Blood flows altered
Ischemia develop
Necrosis Cerebral edema
Increased intracranial pressure
Herniation of brain
Non specific
neurologic deficit
Specific deficit to the area of
involvement
Brain tumor
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.
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
 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
DIAGNOSTIC STUDIES
 History taking &physical examination
 Neurologic examination
 CT scan
 MRI
 PET scan
 Computer assisted stereotactic biopsy
 ECG
 CSF culture
MANEGMENT OF BRAIN TUMOR
SURGICAL THERAPY
1. Burr hole
2. Craniotomy
3. Cranioectomy
4. Cranioplasty
Ventricular shuts
Radiation therapy
Stereotactic radio surgery
CHEMOTHERAPY
1. TEMOZOLAMIDE
2. BEVACIZUMUB
CORTICOSTEROIDS THERAPY
OTHER THERAPIES
NURSING MANEGMENT
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
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.
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.
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.
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
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
POST OPARATIVE NURSING CARE :
Perform monitoring
Promote mobility
Promote decreased intracranial pressure
Protect safety of patients
Promote electrolyte balance
Promote comfort
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.
CONCLUSION
THANK YOU

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BRAIN TUMOUR

  • 1. ClASS PRESENTATION ON BRAIN TUMOR PRESENTED BY – MANIDIPA BAKSHI ROLL NO – 19 B.SC NURSING 3RD YEAR
  • 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
  • 13. PATHOPHYSIOLOGY Risk factors Normal brain tissue compressed Blood flows altered Ischemia develop
  • 14. Necrosis Cerebral edema Increased intracranial pressure Herniation of brain
  • 15. Non specific neurologic deficit Specific deficit to the area of involvement Brain tumor
  • 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
  • 19. DIAGNOSTIC STUDIES  History taking &physical examination  Neurologic examination  CT scan  MRI  PET scan  Computer assisted stereotactic biopsy  ECG  CSF culture
  • 21. SURGICAL THERAPY 1. Burr hole 2. Craniotomy 3. Cranioectomy 4. Cranioplasty
  • 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.