Braintumor 160822132617

Brain tumor
Outlines
 Introduction
 Definition
 Classification of brain tumors
 Risk factors for brain tumors
 Signs and symptoms of brain tumor
 Diagnosis of brain tumor
 Treatment of brain tumor
 Nursing management
Brain tumor
Introduction
Brain tumors
Brain tumors
Brain tumors
Definition of brain tumor
A brain tumor is a
localized intracranial
lesion which occupies
space within the skull
and may cause a rise in
intracranial pressure.
Incidence of tumors
per 100.000 population per year 10-25 
among all tumors 5-15% 

Tissue of origin •
tumor location
(Primary or secondary (metastatic •
(Grading (benign or malignant •
Classification of brain tumors
Tumors of neuroepithelial tissue 1.
Astrocytic tumors ►
Oligodendroglial tumors ►
Ependymal tumors ►
Mixed gliomas ►
Choroid plexus tumors ►
Neuronal and mixed neuronal-glial tumors ►
Pineal parenchymal tumors ►
Embryonal tumors ►
Tumors of cranial and spinal nerves 2
Tumors of the meninges 3
Tumors of meningothelial cells ►
Mesenchymal nonmeningothelial tumors ►
Primary melanocytic lesions ►
Tumors of sellar region 2

Germ cell tumors 3
Lymphomas and hemopoietic neoplasms 4
Cysts and tumor-like lesions 5
Local extensions from regional tumors 6
Metastatic tumors 7
Unclassified tumors 8
Classification of brain
tumors
Brain tumors can be benign or malignant
Benign brain tumors:
 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.
(…(cont
However, benign tumors can press on
sensitive areas of the brain and cause
serious health problems.
 Unlike benign tumors in most other

parts of the body, benign brain tumors
are sometimes life threatening .
 Very rarely, a benign brain tumor may

become malignant.
(…(cont
Malignant brain tumors:
 Malignant brain tumors are generally
more serious and often is life
threatening. It may be primary (the
tumor originate from the brain
tissue) or secondary (metastasis
from others tumor elsewhere in the
body).
 They are likely to grow rapidly and

invade the surrounding healthy brain
(…(cont
 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.
Surgical classification of brain
tumors
Intracerebral 
Intraventricular 
Extracerebral 
Supratentorial 
Infratentorial 
Exact localization (lobes, basal ganglia, brain 

(stem, ventricles
Primary – unknown •
Metastatic •
lung - 35% o
breast - 20% o
kidney - 10% o
gastrointestinal tract - 5% o
Often unknown •
:Under investigation •
Genetic changes o
Heredity o
Errors in fetal development o
Ionizing radiation o
(Electromagnetic fields (including cellular phones o
(Environmental hazards (including diet o
Viruses o
Injury or immunosuppression o
Risk factors of the brain
tumor
 B eing male
 A ge
 F amily history
 B eing exposed to radiation
or certain chemicals at
work
Signs and symptoms of brain
tumor
 Symptoms related to increased intracranial
pressure such as:
 Headache most common in the
early morning and made worse
by coughing or straining
 Decrease in level of
consciousness such as
confusion and lethargy.
Signs and symptoms of brain tumor
(…(cont
Vomiting
Papilledema ( edema of
optic nerve) and visual
disturbance
Alteration in mental status.

Signs and symptoms of brain tumor
(…(cont
Localized symptoms such as:

 A phasia
 P ersonality changes as in
case of frontal lobe tumor
 S ensory defects ( smell,
hearing).
 S eizures.
 M otor abnormalities
Cerebellar tumors •
Disturbances in coordination and equilibrium o
Pituitary tumors •
Endocrine o
dysfunction
Visual deficits o
Headache o
Frontal Lobe •
Inappropriate behavior o
Personality changes o
Inability to concentrate o
Impaired judgment o
Memory loss o
Headache o
Expressive aphasia o
Motor dysfunctions o
Parietal lobe •
Sensory deficits o
Paresthesia 
Loss of 2 pt discrimination 
Visual field deficits 
Temporal lobe •
Psychomotor seizures – temporal lobe-judgment, o
behavior, hallucinations, visceral symptoms, no
convulsions, but loss of consciousness
Occipital lobe •
Visual disturbances o
Diagnosis of brain tumor
 N eurological examination
 B rain CT scan
 M RI on brain
 A ngiogram
 B iopsy
Neuroimaging of brain tumors
Major diagnostic modality. Useful for 
preoperative planning
The diagnosis of a primary brain tumor is best 
made by cranial MRI. This should be the first
test obtained in a patient with signs or symptoms
suggestive of an intracranial mass. The MRI
scan should always be obtained both with and
(.without contrast material (gadolinium
MRI superior to CT scan for evaluating 
meninges, subarachnoid space, posterior fossa
and defining the vascular abnormality of the
lesion
Neuroimaging
High-grade or malignant gliomas appear as 
contrast-enhancing mass lesions, which arise in
white matter and are surrounded by edema
Multifocal malignant gliomas are seen in ~ 5% of 
.patients
Low-grade gliomas typically are nonenhancing 
lesions that diffusely infiltrate brain tissue and
may involve a large region of brain. Low-grade
gliomas are usually best appreciated on T2-
.weighted MRI scans
Neuroimaging
A contrast-enhanced CT scan may be used if 
MRI is unavailable. CT may be false-negative in
patients with a low-grade tumor and can have
significant artifact through the posterior fossa,
. which may obscure a lesion in this area
Calcification, which may suggest the diagnosis 
of an oligodendroglioma, is often better
. appreciated on CT than on MRI
CT useful if there is a question of bone or 
vascular involvement, or for detecting mets to
skull base. Also, in ER situation or if MRI is
.contraindicated
Brain Meningioma CT
Meningioma MRI /T2
Coronal T1-weighted magnetic resonance images 
show a parasagittal malignant meningioma (left) and
its recurrence (right) 8 months after gross total
.resection and external beam radiation therapy
Postcontrast 
computed
tomography
showing relatively
homogeneous
enhancement in
.medulloblastoma
Radiologic features of metastatic
disease
Multiple lesions-
Localization at the grey-white-
junction
More circumscribed margins-
Relatively large amount of-
edema compared to size of
lesion
Treatment of brain tumor
 A variety of medical treatment
modalities, including
chemotherapy and radiotherapy,
are used alone or in combination
with surgical resection .
 Supportive care include:
 Steroids
 Anticonvulsant drugs
Damages DNA of rapidly dividing cells •
Gy total dose 6000–4000 •
Duration of 4–8 weeks •
Brachytherapy •
Stereotactic radiosurgery •
Slows cell growth •
Cytotoxic drugs •
Cisplatin, Etoposide, Vincristine, Temozolomide o
((Temodar
Ommaya Reservoir •
?Do you know what’s in people’s head

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Brain tumor

per 100.000 population per year 10-25 

among all tumors 5-15% 

Choroid plexus tumors ►

Neuronal and mixed neuronal-glial tumors ►

Pineal parenchymal tumors ►

Mesenchymal nonmeningothelial tumors ►

Primary melanocytic lesions ►

Tumors of sellar region 2

 The border or edge of a benign brain

 Unlike benign tumors in most other

 Very rarely, a benign brain tumor may

 They are likely to grow rapidly and

Exact localization (lobes, basal ganglia, brain 

Alteration in mental status.

Localized symptoms such as:

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