Brain tumor

Preabered by Dr. bushra Kirallah

2nd semester -2024-2025
 Brain tumors
Is a collection, or mass, of abnormal
cells in the brain. It can be cancerous
(malignant) or noncancerous (benign).
tends to cause a rise in intracranial
pressure.
 What causes brain tumor?

The exact cause of brain cancer is 

unknown.
Primary brain tumors begin when normal 
cells acquire errors (mutations) in their
DNA.
These mutations allow cells to grow and 
divide at increased rates and to continue
living when healthy cells would die. The
result is a mass of abnormal cells, which
forms a tumor.
However, factors that can the risk of brain 
cancer include:
exposure to high doses of radiation 
family history of brain cancer 
 Cancer in another part of the body 
long-term smoking 
working with elements that can cause 
cancer, such as lead, plastic, rubber,
petroleum,
 Types of Brain tumor

 Brain tumors can be classified as:

 Primary-Arising from the tissues within the
brain
 Secondary-It results from metastasis from
a malignant neoplasm that originates in
some other parts of the body
 Brain tumors can also be classified as

Benign brain tumors do not contain 

cancer cells. Usually, benign tumors can be
removed, and they seldom grow back. The
border or edge of a benign brain tumor can
be clearly seen. Cells from benign tumors
do not invade tissues around them or spread
to other parts of the body.
 Malignant brain tumors

Malignant brain tumors are generally more 

serious and often life threatening.
. They are likely to grow rapidly and crowd 
or invade the surrounding healthy brain
tissue.
 Types of brain tumor depending on the
tissue of origin

Astrocytomas-These are called gliomas. It 

arises from star shaped cells called glial
cells. It accounts for about 65% of the
primary brain tumors. These tumors can
range from low grade to moderate grade
malignancy.
In adults, astrocytomas most often arise in 
the cerebrum
In children, they occur in the brain stem, 
the cerebrum, and the cerebellum
 Glioblastoma Multiforme- 
It arises from the primitive stem 
cells(glioblast).They are highly malignant
and invasive, among the most devastating of
primary brain tumors
 Oligodendroglioma 
Tissue origin is Oligodendrocytes.It is 
characterized by benign encapsulation and
calcification
 Ependymoma 
It arises in the ependymal epithelium. It 
ranges from benign to malignant, most are
benign and encapsulated..
 Acoustic neuroma 
(Schwannoma)-Cells arises from the 
myelin sheath around the nerves,
commonly affects cranial
nerve 
 Pituitary Adenoma 
It arises in the pituitary gland. It is usually 
benign
Hemangoblastoma-It arises from the 
blood vessels of the brain. It is rare and
benign and the surgery is curative.
 Primary central nervous system 
lymphoma
It arises from the lymphocytes. It arises in 
transplant recipients and acquired
immunodeficiency
syndrome(AIDS)patients
 Metastatic tumors 
It occurs in the lungs, breast, kidney, 
thyroid, prostate. It is malignant
 Very rarely, cancer cells may break away
from a malignant brain tumor and spread to
other parts of the brain, to the spinal cord,
or even to other parts of the body. The
spread of cancer is called metastasis
 BRAIN TUMOR LOCATIONS AND
PRESENTING MANIFESTATIONS

frontal lobe tumors 

Unilateral hemiplegia, seizures, memory 
deficit, personality and judgment changes,
visual disturbances.
  parietal lobe

 Speechdisturbance( If the tumor is in the

dominant hemisphere inability to write,
unilateral neglect
  occipital lobe
 Blindness and seizures.
 subcortical
 Hemiplegia, other symptoms may depend
on the area of infiltration
  meningeal tumors
 Symptoms are associated with compression
of the brain
 metastatic tumors
 Headache ,nausea or vomiting because of
increased ICP
 Hemiparesis. 
Visual field defects. 
Sensory defects (smell, hearing). 
Seizures. 
 Signs and Symptoms

A brain tumor is usually characterized by a 

progressive course of symptoms over a
period of time.
Symptoms depend primarily on the location 
of the mass and types
Symptoms related to increased intracranial 
pressure will occur.
Decrease in level of consciousness. 
Confusion.
Headache, Lethargy, Vomiting.
Papilledema-(edema of optic nerve).
Aphasia.
 Medical and Nursing Management

Instruct patient and family about the 

necessity and importance of diagnostic tests
to determine the exact location of the
tumor.
Monitor and record vital signs and neuro 
status accurately q2-4h, or as ordered.
 Report changes to charge nurse 
immediately.
Institute measures to prevent inadvertent 
increases in ICP:
(a) Elevate head of bed 30º. 
(b) Stool softeners to prevent straining at 
stool (increases ICP)
4) Institute seizure precautions at patient's
bedside
(5) Supportive nursing care is given
depending upon the patient's symptoms
and ability to perform activities of daily
living.
.
 6) Administer all doses of steroids and
antiepileptic agents on time.
(a) Withholding steroids can result in 
adrenal crisis
(b) Withholding of antiepileptic agents 
frequently precipitates seizure.
(7) Surgery (craniotomy) is performed to 
remove neoplasm and alleviate symptoms
 TREATMENT

Treatment goals are aimed at identifying 

the tumor type and location, removing or
decreasing the tumor mass and preventing
and managing increased ICP.
 SURGICAL THERAPY
Craniotomy

The most commonly performed surgery for 

removal of a brain tumor
removes a piece of bone to expose the area 
of brain over the tumor. The Dura mater
(the outermost layer of the brain tissue) is
opened, the tumor is located and then
removed (resected).
 Shunt
To relieve the pressure, a procedure is conducted to 
drain excess or blocked fluid. A shunt is a narrow
piece of flexible tubing (called a catheter) that is
inserted into a ventricle in the brain. The other end
of the tubing is threaded under the scalp toward the
neck, then, still under the skin, threaded to another
body cavity where the fluid is drained and
absorbed.
 Cranicotomy

is a surgery done to remove a part of the 

skull in order to relieve pressure in that area
when the brain swells. A cranicotomy is
usually performed after a traumatic brain
injury. It's also done to treat conditions that
cause the brain to swell or bleed
 radiation therapy

is usually used in follow up care. 

chemotherapy
A group of chemotherapeutic agents called 
nitrosureas are administered. Eg:
Carmustine, lomustine