Critical care management of post-craniotomy tumor removal in a patient with frontal lobe syndrome: A case report

Abstract

Meningiomas commonly occur in women of reproductive age, for whom craniotomy and surgical resection represent the primary treatment modality. Despite this, detailed case reports outlining the core principles of nursing care post-resection are sparse. To address this gap, this report presents the nursing management of frontal lobe syndrome in a patient following craniotomy for meningioma removal. This article used case report design to overview the clinical findings of the patient. A 39-year-old female was admitted to the High Care Unit (HCU) following a craniotomy for surgical resection of a right frontal meningioma. Upon admission, the patient exhibited postoperative headache, marked agitation, hypomanic behaviour, sleep disturbance, and right-sided visual loss. Following a comprehensive clinical assessment, the prioritized nursing diagnoses were identified as: risk for ineffective cerebral tissue perfusion, impaired thought processes, acute pain, impaired skin integrity secondary to the surgical incision, and risk for falls. Nursing interventions were implemented across several domains, encompassing intracranial pressure (ICP) monitoring, serial neurological assessments, cognitive-behavioural management for thought processes, acute pain management, surgical wound care, and fall prevention strategies. These interventions were executed in close collaboration with the neurosurgical and psychiatric teams. Over a five-day stay in the hospital, the patient demonstrated marked clinical improvement: orientation and communication enhanced, agitation attenuated, pain was effectively controlled, and the surgical site exhibited primary intention healing without signs of infection. No secondary complications, such as elevated ICP or falls, were observed. This case highlights the pivotal role of interprofessional nursing care for patients presenting with post-craniotomy frontal lobe syndrome. In high-dependency care environments, early identification of neuropsychiatric sequelae remains essential to optimizing clinical recovery.

Keywords: Frontal lobe syndrome, high-care unit, meningioma, nurses, patient, surgery