Causes, symptoms and treatment of cerebral edema. Prevention

Varieties, reasons

Brain edema occurs:

• vasogenic;
• cytotoxic;
• interstitial;
• osmotic.

The signs of cerebral edema depend on the type of developing pathology.

Causes of disease progression:

1. Vasogenic edema occurs due to increased cerebral vascular permeability.
2. Cytotoxic is the “swelling” of brain cells due to an increase in the amount of fluid inside them.
3. Interstitial edema develops when there is increased pressure of the cerebrospinal fluid in the ventricles of the brain.
4. Osmotic edema - with an increase in the osmolarity of brain tissue.

The most common reasons that cause brain swelling are: brain injury and disruption of its tissues in various pathologies.

Brain edema most often occurs in the following pathological conditions of a traumatic nature:

• brain contusion;
• fracture of the base of the skull;
• intracerebral hematoma;
• subdural hematoma. The prognosis of surgery for cerebral edema depends on its size.

The described pathology develops against the background of such organic brain lesions:

• ischemic and hemorrhagic stroke;
• hemorrhage under the arachnoid membrane;
• tumors;
• infectious diseases - encephalitis (inflammation of brain tissue) and meningitis (inflammation of the meninges).

Extracranial causes of cerebral edema can result from:

• Quincke's edema is a severe allergic reaction of the body;
• infectious diseases - scarlet fever, measles, mumps;
• diabetes;
• liver failure;
• alcoholism.

On our website Dobrobut.com you will find more information about the causes of cerebral edema in a newborn child, the development of pathology in the elderly and other facts.

Signs of cerebral edema

Symptoms depend on how quickly brain swelling develops.

Signs of acute cerebral edema:

• disturbance of consciousness - from slight stupor to a state of coma with cerebral edema;
• convulsions – occur as swelling progresses;
• muscle atony – develops after seizures;
• membrane symptoms.

Gradual increase in edema – additional symptoms of cerebral edema in adults:

• headache;
• nausea and vomiting that does not bring relief;
• movement disorders;
• visual and speech disorders;
• hallucinatory syndrome.

Signs indicating critical development of the condition:

• paradoxical breathing (deep breaths with long gaps between them);
• a sharp decrease in blood pressure;
• unstable pulse;
• increase in body temperature above 40 degrees Celsius.

The appearance of such signs indicates compression of the brain stem, which leads to death.

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Diagnostics

Cerebral edema should be suspected if impairment of consciousness increases, meningeal symptoms are observed, and the patient's condition worsens.

Instrumental methods that are used to confirm the diagnosis of cerebral edema:

• computed tomography (CT);
• magnetic resonance imaging (MRI). This is an important diagnostic method - you can detect swelling of the spinal cord on MRI, and not just the brain.

Of the laboratory research methods, general and biochemical blood tests are important.

It is dangerous to perform a lumbar puncture for diagnostic purposes - displacement of brain structures and jamming of the brain stem in the occipital foramen of the skull may occur.

Treatment of cerebral edema

The main principles of treatment for cerebral edema are:

• dehydration;
• improvement of metabolic processes in the brain;
• etiotropic treatment;
• symptomatic therapy.

What consequences of cerebral edema during stroke and other pathologies will accompany the patient depends on the timeliness and competence of the therapy.

Dehydration therapy

Its purpose is to remove excess fluid from brain tissue. Based on the appointments:

• osmotic diuretics (diuretics);
• magnesium sulfate and glucose solution - they enhance the effect of diuretics and also improve brain nutrition;
• L-lysine escinate - the drug is not a diuretic, but removes fluid.

Improving brain processes

For this purpose the following are appointed:

• metabolic drugs;
• glucocorticosteroids;
• oxygen therapy.

Etiotropic therapy

When treating cerebral edema, it is necessary to eliminate the causes of the development of the pathology and “destroy” the mechanism of edema formation. Destination:

• antibiotics;
• removal of tumors and hematomas;
• shunt operations, after which cerebral blood supply improves

This treatment is carried out after the patient’s condition has stabilized.

Symptomatic therapy

It is aimed at eliminating cramps, vomiting, pain, and so on. In addition to conservative therapy, surgical treatment can be used:

• decompression craniotomy;
• Ventricular drainage.

Diet

Nutrition in the first 1-3 days of AGM is carried out parenterally, for which protein hydrolysates, glucose solutions, amino acids, plasma, albumin, a complex of vitamins, and special nutritional mixtures are administered. The timing of the start of enteral nutritional support through a tube is determined depending on the patient's condition, however, to restore gastrointestinal motility, it should begin as early as possible. For this purpose, special quickly digestible high-calorie nutritional mixtures are used, enriched with vitamins/microelements, a set of essential/essential amino acids in optimal dosages ( Nutrizon Energy , Nutrizon , Berlamin , Nutrizon Protein , etc.). It is recommended to use highly concentrated mixtures to reduce the volume of fluid administered, but at the same time provide the body with the necessary amount of calories. The patient can begin eating by mouth after regression of brain disorders.