A patient with increased intracranial pressure is diagnosed with a brain tumor. The nurse realizes that this patient most likely has:

Question

1. An astrocytoma
2. A meningioma
3. A tumor less than 1 mm in size
4. A tumor greater than 1 mm in size

Answer 1

4
Rationale 1: Astrocytomas are grade I and II tumors that grow slowly and the first symptom is seizures. A late symptom is increased intracranial pressure.
Rationale 2: Meningiomas are extremely slow growing tumors. There is a low incidence of the development of increased intracranial pressure.
Rationale 3: Tumors of less than 1 mm in size do not result in the development of cerebral edema as there is minimal displacement of cerebral tissue.
Rationale 4: Brain tumors appear to cause symptoms by different mechanisms. One mechanism is the development of cerebral edema. Cerebral edema appears to develop once tumors have increased in size beyond 1 mm. The new blood vessels that feed the tumor lack the normal blood-brain barrier and are more permeable to macromolecules, proteins, and ions, resulting in vasogenic cerebral edema. Simultaneously, macrophages and inflammatory mediators that increase vascular permeability and edema are released.