Brain Tumors/Test 3 Flashcards
Brain Tumors: Types
- Primary
* Secondary
Primary brain tumor is:
arising from tissue within the brain and rarely metastasis
Secondary brain tumor is:
Metastasis from a malignant neoplasm elsewhere in the body (most common)
Characteristics of brain tumors:
- Arise from support cells of the brain tissue rather than the neurons
- Location impacts the choice of treatment
- One tumor can have multiple cell types
- Variable rate of growth, degree of malignancy: benign can progress to malignant
- No lypmphatic system in the brain to enhance metastasis outside the CNS
- Blood brain barrier prevents drugs from reaching the brain tumor
Brain tumors are classified by tissue from which they arise:
-gliomas: astrocytoma, glioblastoma multiforme, meningioma
Brain tumors: treatment goals
- Identify the tumor type and location
- Remove or decrease tumor mass
- Prevent/manage increased ICP
Brain Tumors: Surgical Therapy
*preferred treatment, complete surgical removal is not always possible because the tumor is not always accessible or has involved vital parts of the brain. Can reduce tumor mass to decrease ICP.
Brain Tumors/Radiation therapy
*common follow-up after surgery; radiation seeds implanted in brain
Stereotactic radiosurgery…
delivers a high concentration dose of radiation precisely directed at a location within the brain. When surgery is not an option due to location.
Chemotherapy:
limited by difficulty getting drugs across the blood-brain barrier, tumor cell heterogeneity and tumor cell drug resistance
Ivestigational therapy:
Hyperthermia and biologic
Altered spacial perception:
*Anosognosia
Anosognosia:
Apparent unawareness or denial of any loss or deficit in physical function
Loss of proprioceptive skills:
Lack of awareness of where various body parts are in relation to each other and the environment.
Agnosia
Inability to recognize a familiar object by use of the senses
Apraxia
Loss of ability to carry out a learned sequence of movements (dressing, brushing teeth, combing hair)
Spacial relationships:
Loss of ability to judge distance or size or localize objects in space
Brain tumors/bowel and bladder
*Frequency, urgency and urinary incontinence- potential for bladder retraining if cognitively intact
Neurogentic bladder:
frequency and urgency. Unilateral lesion: partial sensation and control of bladder.
*Brain stem: bilateral damage and the loss of control of urination
Motor:
Hemiparesis or hemiplegia on the opposite side of the ischemia site. Initially flaccid then progresses to spastic
Dysphagia:
- Swallowing reflex may be impaired
* Pt will pocket food on the effected side
Dysarthria:
Difficult and defective speech d/t impairment of the tongue or other muscles (parynx facial muscles) essential to speech.
- slurred speech/garbled
- Mental function intact
- May be unable to speak but no deficit in the ability to understand, read or write
Clinical manifestations: Dependent on location
- Pressure headache
- occurs at night or present when waking up
- n/v r/t food
- Symptoms of ICP
- s/s cranial nerve deficit
- Visual changes
- CIII, IV, VI: diplopia
- visual field: optic chiasm
- enlarged blind spot r/t papiledema
- Seizures
- Weakness or hemiparesis: motor cortex
- Speech difficulty: language area
- Alterations in LOC: midbrain
- Personality changes frontal lobe
Brain tumors: Complications
-Ventricle obstruction= hydrocephalus