Presented by: Elaine Moser Bano, RN. 

is a lesion that occupies space within the skull, it grows as mass but can grow diffusely, infiltrating tissue. A lesion is any abnormal


which can have a bullseye or 'target' appearance. Slowly enlarging SOLs can be accommodated by atrophy of adjacent brain or spinal tissue. A space-occupying lesion. e. If a lesion is caused by a tumor it will be classified as malignant versus benign. haematomas.g. Lesions are caused by any process that damages tissues. including head injury electrocution and chemical burns can also cause lesions. A cancerous tumor is an example of a lesion. as is the case with many ulcers. Increased Intracranial Pressure. This has potentially fatal consequences. however the surrounding tissue damaged by a tumor is also a lesion. occupies space and may impinge on nearby structures. Trauma. Lesion is derived from the Latin word laesio which means injury.tissue found on or in an organism. The brain and spinal cord are enclosed by bone. or tumours which form in an area where there is little room for expansion and which therefore compress the normal structures in the area: frequently they occur in the skull. as the name suggests. causing any or all of the following pathophysiologic events. whereas a non space-occupying lesion is simply a hole in the tissue. More rapid enlargement causes a rise in pressure in the affected compartment from the normal level of < 2 kPa (< 15 mmHg). Their size may be specified as gross or histologic depending on whether they are visible to the unaided eye or require a microscope to see. hence expansion of their contents by a space-occupying lesion (SOL) leads to compression and distortion of the tissues of the CNS."Lesions such as abscesses. They are subsequently classified by their features. Intracranial space occupying lesions are tumors or abscesses present within the cranium or skull. Seizure activity and neurologic signs. usually damaged by disease or trauma. An additional classification that is sometimes used is based on whether or not a lesion occupies space. It results to compression and infiltration of tissue and a lot of physiologic changes result. the varieties of lesions are virtually endless.  . Lesions may be classified by the shape they form. a small area of the brain that has turned to fluid following a stroke. Because the definition of a lesion is so broad. and herniation of the soft CNS tissue into adjacent compartments where the pressure is lower.

2010 Time : 01:50 am DIAGNOSIS: Space Occupying Lesion .Identification of the Case: Patient¶s Name: Mr.1980 Status: Married Age: 30 years old Birth Place: Cabawan Agusan del Sur Occupation: Laborer Religion: Roman Catholic Nationality: Filipino Chief Complaint: Headache Admission date: December 23.RD Address: Purok santol Cabawan. Rosario Agusan del Sur Birthday: March 20.

Mr. 3 weeks ago. RD have had a motor accident but due to lack of money he was not able to seek medical treatment. RD is passive in smoking and occasionally drinks. nausea and loss of consciousness. Hypertension Diabetes Mellitus Bronchial Asthma Tuberculosis *Present admission *Previous Operation *Allergies FAMILY MEDICAL HISTORY: Hypertension Diabetes Mellitus Asthma Malignancy .History of Past and Present Illness: Two days prior to admission patient complains of onset of headache followed by blurring of vision. and according to him he does not manifest any symptoms that would made him submit himself to seek for consultation. his symptoms worsen every time he does straineous activities such as carrying heavy objects and barring down. Mr. The first symptom he remembered is headache he thought it was a typical headache he self medicate with Paracetamol every time the pain is present. he just had a bruise on his face and head and some wounds in his hands.

PATHOPHYSIOLOGY Predisposing factor: Genetics Precipitating factor: Head injury secondary to vehicular accident Trauma to the scalp. skull or brain Abrasion. blood & CSF Displacement or shifting of CSF Increase absorption of CSF Decrease Cerebral Blood Volume . laceration. or hem atoma beneath the layers of the tissue Swelling/ Hemorrhage/Edema Limited space for expansion within the skull Causes changes in Volume of the brain tissue. contusion.

Increase Intracranial Pressure Obstructed blood flow and decreased tissue perfusion Brain cannot store oxygen and glucose Altered level of consciousness Nausea &Vomiting confusion headache seizures changes in vital signs(hypertension) visual disturbances If treated: Prognosis depends on extent of brain injury If not treated: Irreversible brain damage Coma Death .

It is caused by the mass invading compression or distorting the pain sensitive structures or by edema that accompanies the lesion. Increase Intracranial Pressure Description Gradual compression of the brain by enlarging lesion. Nausea 8.SYMPTOMATOLOGY: Ideal and Presenting Symptoms 1. Common symptom. Due to increased ICP Due to compression and pressure on blood vessels tends to constrict and increase blood supply. Enlarging occupying lesion Present  2.Involuntary rhyththmical eye movement. Due to increased ICP. Motor Function changes .Homonymous hemianopsia . Visual disturbances . When specific regions of the brain is disrupted alterations in cognitive function occur and language disturbances is present. Vomiting( Projectile) 7. .Visual loss in one half of the visual field. Mental Status changes 4.Nystagmus 6. worsen by coughing. Motor cortex compression . Dull and unrelenting. straining or sudden movement. as its compensatory adjustments may occur through compression of intracranial veins. Increase Blood Pressure    9. Headache  3. Seizure 5.

presses the cerebellum. size. CT SCAN -imaging that gives specific information concerning the number. Studies of the CSF may be performed to detect malignant cells because tumors of the CNS are capable of shedding cells into the CSF. Can detect abnormal brain waves in regions occupied by a tumor and it is used to evaluate temporal lobe seizures and assist in ruling out other disorders. b. Cerebral Angiography - Provides visualization of cerebral blood vessels and can localized most cerebral tumors and mass. c. Cytology - . ECG - e. DIAGNOSTIC TEST: Description: a. abnormalities in motor function may present. it is used in the detection of lesion it is particularly helpful in detecting tumors in the brain stem and pituitary regions where bone interferes with CTscan. and density and extent of the lesions. MRI - Is helpful in the diagnosis of brain tumors/ lesion. d.

To decrease the fluid content of the brain which leads to decrease ICP. Decreases recurrences of incompletely resected tumors/ mass. MEDICAL MANAGEMENT: DRUGS: a. Radiation therapy Allows deep.f. glycerol) d. Craniotomy - . Osmotic agents ( mannitol. Antihypertensive Are useful in relieving headache and alterations of consciousness. Reduces inflammation around the metastatic deposits and decreases the edema surrounding. Pain relievers - SURGERY: a. inaccessible tumors to be treated. Prevent and treat seizure. Corticosteriods b. often in a single session. - c. c. Xray - To localized the tumor/ mass to verify its position. Radio surgery b. To normalizes increase Blood pressure and to manage Increase intracranial pressure. Progression in the doses and type of analgesic agents needed for effective relief. Conventional surgical approach that requires an incision into the skull to release tension. Anticonvulsant (phenytoin) e.

Monitor Vital signs. 2. photograph.use of orienting devices( personal possesions. 7. Glasgow Coma scale/ Motor function evaluation. 2. DEPENDENT NURSING MANAGEMENT: 1. Medicated and Properly Monitored. Neurologic checks/ flow chart . 5. Continuously Administered Intravenous Fluid as ordered. list.NURSING MANAGEMENT: INDEPENDENT NURSING MANAGEMENT: 1. Render health teachings. Reorients the patient when necessary to person.additional support system is needed by them to make their activities of daily living. and place. .is checked at intervals because specific motor deficits may involved. Prevention of injury. imparting knowledge the patietn will be able to lessen the tendency of injury and harm and be able to have idea on how to prevent further determine if there are changes and abnormalities that the patient is manifesting. clock) 4.patients with seizures and paralysis is closely monitored. Assisting in Self Care. 3.monitor cognitive and comprehension of the pt some of them experience neurologis dysfunction. time.

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