Brain Tumors and Brain Surgery

1
Brain Tumors and Brain Surgery

• Cynthia Peacock RN, MSM

2
Objectives

• Identify pathophysiology and clinical
  manifestations of brain tumors.
• Discuss system of classifying brain tumors.
• Discuss laboratory and diagnostic testing
  relating to brain tumors.

3
Objectives

• Compare and contrast treatment modalities
  including pharmacologic (chemotherapy), radiation
  therapy, and intracranial surgery
• Using the nursing process as a framework for
  providing individualized care to a patient having
  intracranial surgery

4
Key Terms

• Benign
• Cerebellar tumor
• Diabetes insipidus
• Frontal lobe
• Gamma knife therapy
• Malignant
• Metastasis
• Syndrome if inappropriate
• antidiurectic hormones secretion (SIADH)
• Transphenoidal

5
Primary Brain Tumors

• Is a localized intracranial lesion that occupies
  space within the skull.
• The effects are related to their compress and
  infiltration
• Clinical manifestations can be
• Increased intracranial pressure (IICP)
• Cerebral edema, seizures, hydrocephalus,
  alteration in pituitary function.

6
Primary Brain Tumors

• Originate from the cells within the brain
• Secondary tumors develop from structures outside
  of the brain.
• Brain tumors rarely metastasized.
• Metastatic lesions commonly occur to the brain
  i.e. lung, breast, colon, pancreas, kidney and
  skin (melanoma).

7
Causes of Brain Tumors

• Is unknown
• Risk factor is exposure to ionizing radiation
• Secondary brain tumors are more common
• Maybe classified as benign or malignant.
• Benign may be misleading, because of the
  potential of growth and the relationship of
  cerebral edema.

8
Clinical Manifestations

• Vary depending on the extent and location of the
  lesion

9
Clinical Manifestations

• Generalized Signs
• IICP
• H/A
• Vomiting
• Visual disturbances
• Focal or localized symptoms (most common)
• Hemaperesis,
• seizures
• Mental changes

10
Assessment and Diagnostic Findings

• The goal is to assist in the precise localization
  of the tumor
• CT with contrast agents
• MRI (most helpful in diagnoses)
• PET
• Biopsy
• Cerebral angiography
• EEG
• Cytologic studies of CSF

11
Medical Management Brain Tumor

• Chemotherapy
• External beam radiation therapy
• Corticosteroids
• Gene transfer
• Photodynamic therapy

12
Surgical Management Brain Tumor

• The objective is to remove or destroy the tumor
  without increasing the neurologic deficit
  (paralysis blindness) or relieve the symptoms by
  partial removal.

13
Craniotomy

• An incision is made through the scalp and a hole
  is drilled through the skull.
• A piece of the skull may be removed while the
  brain is being operated on and replaced before
  the skin is stitched closed.

14
Nursing Management

• Preoperatively the gag reflex and the ability to
  swallow are evaluated
• Neuro checks
• Monitor VS
• Frequent orientation
• Protection from injury
• Monitoring of motor function

15
THE END-Thanks to Professor Sheila J. Coakley
RN, MSN for lecture materials