for PG Nursing students

1. Brain Tumors
Mr. Dipti Sorte

2. Aims & Objectives
•At the end of the class the students will be able to:
1. Define Brain Tumors.
2. Explain Incidences of Brain Tumors.
3. List Etiology of Brain Tumors.
4. Enlist Types of Brain Tumors.
5. Explain Clinical features of Brain Tumors.
6. Describe Management of Brain Tumors.
7. Discuss Nursing Management of Brain Tumors.

3. Introduction:
• Second most commen malignancy during childhood and
adolescent.
• They include (most commonly):
• Medulloblastoma.
• Juvenile pilocytic astrocytoma.
• Low grade Astrocytoma.
• Ependymoma.
• Cranial pharyngioma.
• Majority do not extend locally and do not metastasize.

4. Definition
•A brain tumor is a collection, or mass, of abnormal
cells in your brain. Your skull, which encloses your
brain, is very rigid. Any growth inside such a
restricted space can cause problems. Brain tumors
can be cancerous (malignant) or noncancerous
(benign).
•When benign or malignant tumors grow, they can
cause the pressure inside your skull to increase.
This can cause brain damage, and it can be life-
threatening.

5. Incidences:
•The central nervous system tumors
accounts for approximately 20% of all
childhood cancers, with an estimated
annual incidence are 3.1 cases
per1,00,000 children younger than 15yrs
of age. (Howlader, noon, krapcho and
other 2011)

6. Etiology – Exact is not known
Possibilities are:
• Familial.
• Genetic association.
• Occupational exposure.
• Post-natal irradiation.
• Viruses.
• Age distribution:
• <1 year = Supratentorial.
• Adolescent = Supratentorial.
• 1 to 10yrs = Infratentorial are more commen.

7. Types
1. Primary brain tumors. (Eg. Primary brain tumors originate in your
brain. They can develop from brain cells, the membranes that surround
your brain, which are called meninges, nerve cells. glands
2. Gliomas (Eg. Gliomas are tumors that develop from glial cells. These
cells normally support the structure of your central nervous system,
provide nutrition to your central nervous system, clean cellular waste,
break down dead neurons.
3. Other primary brain tumors (Eg. pituitary tumors, which are usually
benign, pineal gland tumors, which can be benign or malignant,
craniopharyngiomas, which occur mostly in children and are benign but
can have clinical symptoms like changes in vision and premature puberty,
primary central nervous system (CNS) lymphomas, which are malignant)
4. Secondary brain tumors (Eg. Lung cancer, Breast cancer)

8. Clinically:
A. 55% tumors are in posterior fossa so cause:
• Hydrocephalus.
• Cerebellar sign.
• Cranial nerve deficit.
• Long tract signs.
B. Increase ICP present as:
• Morning headache.
• Vomiting.
• Visual disturbance.
• Behavior changes.

9. C. Supratentorial tumor: Present as Headache, Seizures, motor
weakness, sensory changes, speech disorder.
D. Optic pathway tumors: Present as:
• Decreased visual acuity.
• Marcus Gunn pupil.
• Nystagmus.
• Visual field defects.
E. Suprasellar region tumors.
• Diabetes insipidus.
• Hypothyroidism.

10. F. Diencephalic syndrome – Suprasellar and III ventricle tumors.
• Failure to thrive.
• Emaciation.
• Increase appetite.
• Euphoric state.
G. Pineal region tumors: Perinaud syndrome characterized by.
• Paresis of upward Gaze.
• Pupillary dilatation, reaction to accommodation but not to light.
• Nystagmus.
• Eye lid retraction.

11. Management: General principle.
1. Ventricle peritoneal shunt to prevent the bad
effects of hydrocephalus.
2. Modern neurosurgery.
3. Modern Brain radiotherapy.
4. Adjuvant by linear acceleration chemotherapy.

12. Nursing Management
• If brain tumor is suspected in a child admitted to the hospital for cerebral
dysfunction, establishing base line data with which to compare preoperative
and postoperative changes is an essential step. It allows the nurse to asses the
degree of physical capacity and the family’s emotional reaction to the
diagnosis.
• Vital signs including B.P, pulse pressure are taken routinely and more often
when any change is noted.
• Any sudden variations are reported immediately.
• The child is observed for evidence of headache, vomiting and any seizures
activity.
• The location, severity, time of day, any associated factors noted.
• The child’ gate is observed daily.

13. Summary
•The outlook for a brain tumor will depend on:
•The type of tumor
•The size of the tumor
•The location of the tumor
•Your general health
•Early treatment can prevent complications that can occur as
a tumor grows and puts pressure on the skull and brain
tissue. See your doctor if you’re worried about any
symptoms you’re experiencing.

14. References
1. B. Anjaiah, Clinical peditrics, PARAS publication, 3rd edition, Page no.
1052.
2. Julius scott’s, Scott’s Pedia-tricks, Paras medical books, 3rd edition, Pg no
322.
3. Merilyn J. Hockenberry, Essentials of pediatric Nursing, first south asia
edition, pg no 833-835.
4. Parsarthy, K. Nedunchalian, Gowri Shankar HC, Textbook of Balram
chaiudhary’ Pediatrics, Lecture notes, PEE PEE Publication, 2nd edition.
Pg no. 314-320.
5. A. Parsarthy, PSN Menon, Rohit Agrawal, IAP Textbook of pediatrics,
IAP National publication house Gwaliar. Pg no. 369.
6. https://www.healthline.com/health/brain-tumor.

15. Thank you