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Brain edema is a build-up of fluid in the brain. Brain edema may develop discreetly, but symptoms can also appear suddenly. The cause of cerebral edema can be both meningitis and the development of some kind of tumor of the central nervous system. In case of suspicion of cerebral edema, the patient should see a doctor promptly, as cerebral edema is a life-threatening pathology.

Brain edemais a disorder in which there is an accumulation of fluid in or within the brain. There are at least four types of cerebral edema:

  • vascular cerebral edema : it is associated with impaired functions of tight connections between vascular endothelial cells, which result in the penetration of proteins and fluid from blood vessels into the brain tissues (generally pathologies concern here the so-called blood-brain barriers);
  • cytotoxic cerebral edema : in its course, the disorders affect the brain cells themselves; as a result of various processes (e.g. hypoxia or poisoning), the membrane transporters of various ions malfunction, which results in excessive accumulation of e.g. sodium or calcium ions inside the cells of the nervous system, and this in turn causes the inflow of fluid to them and the development of edema ;
  • osmotic swelling of the brain : it occurs when the osmolality of the blood decreases (it may result, for example, from a reduction in the content of sodium ions in it), which may cause excess fluid to start get from the blood into the cerebrospinal fluid and into the brain tissues themselves;
  • interstitial swelling of the brain : caused by disturbances in the functioning of the barrier between the cerebrospinal fluid and brain tissues.

Cerebral edema - causes

There are many pathologies that can lead to the development of cerebral edema, including:

  • stroke
  • encephalitis
  • head injury
  • cancer of the central nervous system
  • meningitis
  • intracranial hemorrhage
  • severe hypertension
  • altitude sickness
  • poisoning (e.g. with dinitrophenol)
  • Reye's syndrome
  • severe hypoxia
  • hyponatraemia (reduction ofserum sodium concentration)
  • syndrome of inappropriate vasopressin secretion (SIADH)

Swelling of the brain - symptoms

Symptoms of cerebral edema may vary depending on both the cause of the condition and the rate at which the edema is progressing. In addition, the symptoms can arise both suddenly and gradually worsen. Problems that may occur in the course of cerebral edema include:

  • headache
  • neck stiffness
  • nausea
  • vomiting
  • visual disturbance
  • seizures
  • dizziness
  • memory, concentration and attention disorders
  • speech disorder
  • ataxia

When the swelling of the brain becomes significant, various disturbances of consciousness can occur - patients may even fall into a coma. Brain edema should definitely be treated as a potential life-threatening condition - in its case there is a risk that the brain stem will be wedged, and the consequence of such a phenomenon may even be a complete stoppage of breathing and the patient's death.

Brain edema - diagnosis

Imaging tests play a role in the diagnosis of cerebral edema. On the basis of such examinations as, for example, computed tomography or magnetic resonance imaging of the head, it is possible to identify changes characteristic of this unit, such as narrowing of the elements of the ventricular system, general enlargement of the dimensions of the brain or flattening of its gyruses.

Cerebral edema - treatment

Treatment of patients with cerebral edema involves both causal and symptomatic management. It is certainly important to take measures to eliminate the cause of brain edema, but the most important thing is to reduce the degree of cerebral edema present in patients.

Pharmacological treatment of this condition is based on the intravenous administration of an osmotically active mannitol or a diuretic furosemide, and glucocorticoid preparations (e.g. dexamethasone) may also be used.

Sometimes doctors cause hyperventilation in patients with cerebral edema or make them hypothermic.

In the case of significant cerebral edema associated with a high risk of impaction, the patient may be treated with a surgical treatment consisting of a cranioctomy (temporary removal of the skull bone) or a craniectomy (permanent removal of the skull bone). The idea is to relieve tissue pressure and minimize possible brain damage.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań.An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Neurology