AANN Core Curriculum, 7th Edition, Ch. 19 Nervous System Tumors: Digital Version-Chapter 19

Chapter 19

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Nervous system tumors are classified by origin, location, histology, molecular features, and whether they are primary or metastatic. Primary CNS tumors include gliomas, meningiomas, ependymomas, embryonal tumors, lymphomas, sellar tumors, and nerve-sheath tumors. Spinal tumors are categorized as extradural, intradural-extramedullary, or intramedullary; peripheral nerve tumors include usually benign schwannomas and neurofibromas, as well as aggressive malignant peripheral nerve sheath tumors. Brain metastases most often arise from lung, breast, melanoma, renal, or colorectal cancers.<br /><br />Symptoms depend on tumor site and may include progressive or positional headaches, nausea and vomiting from raised intracranial pressure (ICP), seizures, cognitive or personality changes, visual or speech problems, weakness, gait or coordination difficulties, and focal sensory or motor deficits. Spinal tumors may cause pain, numbness, weakness, and bowel, bladder, or sexual dysfunction; suspected acute cord compression requires emergency imaging and neurosurgical assessment.<br /><br />MRI is central to diagnosis and monitoring. Other imaging, CSF studies, and tissue biopsy may be needed; histological and molecular testing helps establish diagnosis, prognosis, and treatment. Care is multidisciplinary and may include maximal safe resection or biopsy, radiation (including stereotactic techniques), chemotherapy, and, in selected cases, tumor-treating fields or other targeted approaches. Treatment depends on tumor type, location, molecular profile, symptoms, and patient condition.<br /><br />Nursing care includes frequent neurological assessment, monitoring after surgery, seizure precautions, and management of ICP, pain, fatigue, nausea, constipation, and treatment side effects. Corticosteroids may reduce tumor-related edema; monitor for adverse effects such as hyperglycemia, insomnia, mood changes, and muscle weakness. Rehabilitation supports function and independence. Clear education, psychosocial and family support, counseling, and palliative care help address emotional, practical, and quality-of-life needs, particularly with progressive or incurable disease.

Keywords

nervous system tumors

primary CNS tumors

brain metastases

spinal tumors

peripheral nerve tumors

gliomas

magnetic resonance imaging

raised intracranial pressure

neurological symptoms

multidisciplinary treatment