cerebral edema

Cerebral edema is a pathological condition in which excessive accumulation of water occurs in the tissues of the brain and spinal cord due to disruption of its normal movement and metabolic disorders.

Causes of cerebral edema

    • may occur as a result of the direct impact of the pathological process on the nervous system (trauma, brain tumors, infectious lesions of the brain, spinal cord and their membranes),
    • may accompany some somatic diseases (general infections, cardiovascular and hepatic diseases, burns, etc.).

Varieties of cerebral edema

According to the pathogenesis, cerebral edema is divided into vasogenic, cytotoxic, interstitial and filtration.

Depending on the etiological factor, there are tumor, traumatic, postoperative, toxic, inflammatory, ischemic and hypertensive cerebral edema.

The main symptoms of cerebral edema

Clinical manifestations of edema-swelling of the brain are the same regardless of its pathogenetic type.

They consist of a combination of three groups of symptoms: due to the syndrome of intracranial hypertension, focal and stem symptoms.

Treatment of cerebral edema

One of the main tasks in the treatment of a patient with intracranial pathology in the acute period is to ensure that he has a normal level of central perfusion pressure (CPP), since it determines the sufficiency of blood supply and the supply of nutrients to the neuron.

CPP is determined by the formula:

CPP = mean arterial pressure (MAP) – intracranial pressure (ICP) – central venous pressure (CVP).

Cerebral edema leads to the development of intracranial hypertension, i.e. an increase in ICP and, accordingly, a decrease in CPP.

Treatment of edema-swelling of the brain involves

      • maintenance of oxygenation (pO2> 70 mm Hg), if necessary, transfer to mechanical ventilation
      • elimination of motor excitation and convulsions
      • prevention and elimination of pain and nociceptive reactions
      • elimination of the causes that violate the venous outflow from the cranial cavity
      • maintaining normal body temperature
      • moderate hyperventilation
      • prescription of diuretics

With the ineffectiveness of conservative treatment, a decompression trepanation of the skull is performed, by removing a bone flap in order to reduce ICP increased due to cerebral edema.

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