Causes, symptoms and treatment of cerebral edema
Cerebral edema is the rapid accumulation of fluid in its tissues, which can be fatal. Knowing the symptoms of cerebral edema in adults and children will ensure timely diagnosis and adequate treatment.
Varieties, causes
Swelling of the brain happens:
- vasogenic;
- cytotoxic;
- interstitial;
- osmotic.
The signs of cerebral edema depend on the variety.
Vasogenic edema occurs due to increased permeability of cerebral vessels.
Cytotoxic edema is the ""swelling"" of brain cells due to an increase in the amount of fluid inside them.
Interstitial edema develops with increased pressure of the cerebrospinal fluid of the ventricles of the brain.
Osmotic edema develops when the osmolarity of brain tissues increases.
The most common causes of brain swelling are: brain trauma; disorders in its tissues in various pathologies.
Swelling of the brain most often occurs in the following pathological conditions of a traumatic nature:
- cerebral contusion;
- fracture of the base of the skull;
- intracerebral hematoma;
- subdural hematoma. The prognosis of surgery for cerebral edema depends on its size.
The pathology described develops against the background of the following organic lesions of the brain:
- ischemic and hemorrhagic stroke;
- hemorrhage under the spider web;
- tumors;
- infectious diseases - encephalitis (inflammation of brain tissue) and meningitis (inflammation of the meninges).
Extracranial causes of cerebral edema can lead to:
- Quincke's edema is a pronounced allergic reaction of the body;
- infectious diseases - scarlet fever, measles, mumps;
- diabetes;
- liver failure;
- alcoholism.
On our site Dobrobut.com you will find more information about the causes of cerebral edema in a newborn child, the development of pathology in the elderly, etc.
Symptoms of cerebral edema
Symptoms depend on how quickly brain swelling develops.
Symptoms of acute cerebral edema:
- disorder of consciousness - from light clouding of consciousness to a state of coma due to cerebral edema;
- convulsions - they occur during the progression of edema;
- muscular atony - develops after seizures;
- membranous symptoms.
Gradually increasing edema - additional symptoms of cerebral edema in adults:
- headache;
- nausea and vomiting that does not bring relief;
- motor disorders;
- impairment of sight and speech;
- hallucinatory syndrome.
Signs that indicate a critical development of the condition:
- paradoxical breathing (deep breaths with long intervals between them);
- a sharp decrease in blood pressure;
- unstable pulse;
- an increase in body temperature above 40 degrees Celsius.
The appearance of such signs indicates compression of the brain stem, which leads to death.
Diagnostics
It is worth suspecting cerebral edema if the disturbance of consciousness increases, meningeal symptoms are observed, and the patient's condition worsens.
Instrumental methods used to confirm the diagnosis of cerebral edema:
- computed tomography (CT);
- magnetic resonance imaging (MRI). This is an important method of diagnosis - this is how you can detect swelling of the spinal cord on an MRI, and not just the brain.
Of the laboratory research methods, general and biochemical blood analysis are important.
It is dangerous to carry out a lumbar puncture for the purpose of diagnosis - displacement of brain structures and jamming of the brain stem in the occipital opening of the skull may occur.
Treatment of cerebral edema
Main principles of cerebral edema therapy:
- dehydration;
- improvement of metabolic processes in the brain;
- etiotropic treatment;
- symptomatic therapy.
The consequences of cerebral edema in stroke or other pathologies depend on the timeliness of therapy.
Dehydration therapy
Its purpose is to remove excess fluid from brain tissue. The basis of 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 processes in the brain
For this purpose, the following are appointed:
- metabolic drugs;
- glucocorticosteroids;
- oxygen therapy.
Etiotropic therapy
In the treatment of cerebral edema, it is necessary to eliminate the cause and ""destruction"" of the mechanisms of the formation of cerebral edema. Appointment:
- antibiotics;
- removal of neoplasms and hematomas;
- shunt operations, after which cerebral blood supply improves.
Such treatment is carried out after the patient's condition has stabilized.
Symptomatic therapy
It is aimed at eliminating convulsions, vomiting, pain syndrome, etc.
In addition to conservative therapy, surgical treatment can be used:
- decompression trepanation of the skull;
- ventricle drainage.
Prevention
To prevent cerebral edema, pathologies that lead to its development should be prevented, and if they occur, they and accompanying pathologies should be diagnosed and treated in a timely manner to avoid an undesirable consequence. For example, death can occur from swelling of the brain and lungs.
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