OBJECTIVE To review current management of individuals with metastases to the central nervous system and brachial nerve plexus, and to provide a scientific basis for nursing management of the effects of the disease and treatment. METHODS Published articles, book chapters, clinical trial data, and experience from nursing literature. CONCLUSIONS Central nervous system metastases are events that may create oncologic emergencies with neurologic impairment and pain. Treatment of patients with central nervous system metastases is generally palliative regardless of the type of the primary cancer. Early diagnosis and treatment improve the chances for optimal recovery of neurologic function and pain management. CONCLUSIONS Central nervous system metastases may develop in patients with systemic disease. Disease and treatment effects present challenges to patients, family, and care providers. Nurses have a responsibility in educating the patient/family and in providing supportive care.