Edema swelling of the brain. What to do in case of cerebral edema. Interstitial cerebral edema

Cerebral edema is a serious pathology that inevitably leads to death if left untreated. The disease is especially dangerous for children, because it has hidden symptoms and causes a number of disorders. In adults, it flows more easily, but it will not work to cure it on its own. What is this disease and what factors provoke it?

Cerebral edema is a reactive process that occurs when there is an excessive concentration of fluid in the brain cavities and tissues. This severe disease is accompanied by an increase in intracranial pressure and damage to blood vessels, causing nerve cells to die.

Pathology develops during hypoxia, accompanied by an increase in the level of carbon dioxide in the body.

Cerebral edema is provoked by the following factors:

Skull damage. Sometimes there is injury to the brain fragments of cranial bones. All this causes severe edema, which prevents the outflow of fluid.
Brain injury.
Ischemic stroke, which disrupts cerebral circulation due to blockage by a clot clot. It prevents the cells from receiving a normal amount of oxygen, after which they die, causing swelling.
Hemorrhagic stroke, which develops with damage and aneurysm of blood vessels and provokes an increase in intracranial pressure.
Meningitis- inflammation of the meninges.
Intracranial hematomas.
Metastasis of tumors in brain tissue.
Toxoplasmosis- a disease caused by the protozoan toxoplasma. It is especially dangerous for the fetus developing in the mother's womb.
Purulent infection, which, with a rapid flow, becomes a source of swelling, preventing the outflow of fluid.
Tumors that disrupt blood circulation when squeezing individual parts of the brain.
Encephalitis- inflammation of the brain of a viral nature, carried by insects.
Height differences. Above 1.5 km above sea level, due to lack of oxygen, cerebral edema begins. This is one of the symptoms of altitude sickness.
Intoxication neuroparalytic poisons, alcohol, chemicals.
Damage to the liver, biliary tract.
Operations on brain tissues.
Anaphylactic reactions.
Anasarka- edema, accompanied by heart failure.

Cerebral edema is dangerous because this organ is limited by the size of the cranium and is not able to increase its volume without consequences for the whole organism. Compression of the skull, combined with a drop in oxygen levels, entails a complete cessation of the blood supply to neurons, increasing swelling.

What contributes to the disease

The following factors contribute to the occurrence of the disease:

An increase in blood pressure by increasing it in the capillaries. This is due to the expansion of the cerebral arteries. In fact, water accumulates in the intercellular space.
Violation of vascular permeability. As a result, the pressure in the intercellular space rises, which causes damage to the cell membranes.

In an adult, the intracranial pressure in the supine position ranges from 3-15 mm Hg. Art. In some situations (when coughing, sneezing, increased intra-abdominal pressure), the indicator reaches 50–60 mm Hg. Art., but this does not cause disturbances of the human nervous system, since it quickly passes due to the internal mechanisms of cerebral protection.

At-risk groups

Cerebral edema is more prone to:

People, having problems with the cardiovascular system. These include past ischemic disease, hypertension, atherosclerosis.
Sick, whose professions are associated with the risk of injury, falling from a height.
adults, alcoholics. With excessive use of alcoholic beverages under the influence of ethanol, nerve cells die, and fluid accumulates in their place.
Newborns passing through the birth canal.

Symptoms

Appearing locally, the pathology quickly covers the entire organ. In some cases, the disease develops gradually, therefore, by detecting the first signs of edema, the patient's life can be saved.

Symptoms depend on the origin of the formation and the severity of the disease. The most common signs are:

nausea and vomiting;
headache, manifested in acute diseases of the brain;
memory disorders;
forgetfulness;
blurred vision;
lowering blood pressure, unstable pulse;
pain in the neck;
uneven breathing;
speech problems;
frequent dizziness;
lack of coordination;
paralysis of the limbs;
convulsions, turning into muscle atony (inability to contract);
hallucinations;
with alcoholic edema, swelling of the face is observed with the formation of many hematomas;
loss of consciousness, with aggravation of the situation turning into a coma.

Cerebral edema happens:

local affecting a specific area of the brain;
diffuse covering the brainstem and hemispheres.

In this case, diffuse edema has more pronounced symptoms.

But the following types of edema are also distinguished:

Cytotoxic edema occurs due to hypoxia, intoxication and ischemia. Pathologically, the amount of gray matter increases.
Vasogenic edema is formed when the blood-brain barrier is broken. It occurs in the presence of a tumor, abscess, ischemia, and also after surgery. This pathology is manifested in an increase in the amount of white matter and is perifocal, which leads to compression of the brain.
Osmotic edema develops with an increase in blood glucose and sodium. It leads to dehydration of the brain, and then to complete dehydration of the body.
interstitial edema is formed due to the penetration of water into the brain tissue.

What causes pathology

Edema is often fatal, causing irreversible damage to brain tissue. Modern medicine cannot guarantee a patient's recovery even with proper therapy.

Cerebral edema threatens the following conditions:

Progression of edema causing death of the patient. These effects are typical for most victims. A person is in a stable condition if there is free space in the cranial cavity. When it is completely filled with fluid, the brain becomes constricted. At the same time, the dense structures of the brain become soft. Thus, the tonsils of the cerebellum are wedged into the trunk, resulting in the cessation of breathing and heartbeat of a person.
Elimination of edema without consequences for the brain. This outcome is rare and possible for young people if the swelling is caused by intoxication.
Getting rid of edema, while the patient becomes disabled. This is how the edema that has formed during infectious diseases, minor injuries and hematomas ends. In this case, disability may not be visually manifested.

After such a pathology in adults, there are:

frequent headaches;
distraction;
convulsions;
problems with coordination;
bad sleep;
defects in physical development;
disorder of communication skills;
breathing problems;
depression;
epilepsy;
paralysis;
coma;
a vegetative state, when the patient is not aware of and does not respond to the environment, since the function of the cerebral cortex has been lost.

Cerebral edema in children

The skull of newborns has its own characteristics. The skull bones are connected by cartilage as the child's brain continues to grow.

Reasons for the appearance

The accumulation of fluid in the brain in children is provoked by:

intrauterine fetal hypoxia;
congenital pathologies of the nervous system;
birth injury;
accumulation of pus in the brain;
transferred infections in utero;
meningitis and encephalitis;
increased amount of sodium in the blood (observed in premature babies);
congenital tumors in the head.

Symptoms of puffiness

The following signs indicate cerebral edema in an infant:

drowsiness;
anxiety;
breast rejection;
tachycardia;
strong cry;
pupil dilation;
lethargy;
temperature rise;
tension or swelling of the fontanel;
vomit;
an increase in the size of the head;
convulsions.

With untimely assistance, the child's condition worsens, the disease develops quickly and ends in death.

If the child is prone to edema, it must be observed by a neurologist to exclude intracranial pathology, which will increase the chances of survival. The most dangerous period for a baby is a month after childbirth.

Possible Complications

The consequences of the disease in children are:

decrease in intellectual skills;
violation of the functioning of the body (lack of reflexes, inability to hold the head);
insufficient development of communication skills;
epilepsy;
death.

Features of diagnostics

If you suspect swelling of the brain, the patient is prescribed:

examination by a neurologist and ophthalmologist;
blood analysis;
examination of the cervical region;
MRI and CT of the brain;
neurosonography for children up to a year.

In the early stages of the disease, when the symptoms are mild, an examination of the fundus will be required. Edema will be indicated by stagnation of the optic discs, pupillary reaction, characteristic movements of the eyeballs.

Puffiness treatment

The therapeutic course consists of a set of procedures aimed at:

fight progression swelling of the brain;
removal of the cause puffiness;
treatment of symptoms causing complications and aggravating the patient's well-being.

The causes of cerebral edema are eliminated:

antibiotic treatment: cefepime, cefuroxime;
the appointment of calcium channel blockers: fendiline, verapamil, nimodipine;
elimination of toxins;
normalization of vascular tone;
elimination of the tumor if the patient's condition is stable;
improved blood circulation;
withdrawal of liquor.

In the treatment of this pathology, it is necessary to control the cardiovascular system and body temperature, since its increase exacerbates swelling.

When diagnosing cerebral edema, the patient is subject to hospitalization. He is placed in the intensive care unit, and the vital functions of the patient are supported artificially.

Only swelling of a small size or resulting from mountain sickness can go away on its own.

The main methods of treatment:

medication;
oxygen therapy;
with the help of surgery.

Medical treatment

For treatment, a complex of drugs is prescribed:

Diuretics for removing excess fluid from tissues: lasix, sorbitol, furosemide, mannitol. They have a diuretic effect and are used in combination with glucose and magnesium sulfate to enhance the action.
Decongestant drug L-lysine aescinat.
Installations to increase the saturation of tissues with oxygen, and, if necessary, artificial ventilation of the lungs.
Mexidol, context, actovegin, ceraxon improve metabolism.
Muscle relaxants to eliminate seizures.
Glucocorticoid hormones: prednisolone, dexamethasone, cortisone, hydrocortisone. They stabilize the membrane of the affected cells, strengthening the vascular walls.

oxygen therapy

This method involves the introduction of oxygen directly into the blood by artificial means. This manipulation provides nutrition to the brain, helping to eliminate swelling.

Surgical intervention

With the help of surgery, the cause that caused the swelling of the brain tissue is removed. This is the only way to get rid of a dangerous disease if it was provoked by a neoplasm, a violation of the integrity of blood vessels, or traumatic injuries to the skull.

The fluid accumulated in the head is removed by a catheter, which reduces intracranial pressure.

Operations performed on the brain are among the most complex.

Forecast

The prognosis of the disease is influenced by the timeliness of treatment. Swelling puts a lot of pressure on the brain, which can damage vital nerve centers. As a result of the death of neurons, paralysis or coma occurs.

The degree of development of the disease plays a huge role.

Perifocal edema is easier to cure, but it will not be possible to restore all the lost functions of the patient.

Prevention

Disease can be avoided if safety rules are followed. These include:

fastening seat belts;
wearing a helmet when cycling, rollerblading, working on a construction site;
passage of acclimatization during mountaineering;
to give up smoking;
constant control of blood pressure.

Conclusion

Cerebral edema is a dangerous condition, most often due to trauma to the skull or infection. When the first signs of illness appear, you should consult a doctor who, after a series of procedures, will prescribe a course of treatment. If the disease is detected in the early stages, it can be cured with medications. At the same time, a protracted pathology is treated only by surgery and will leave complications of varying severity for life.

This dangerous rapidly developing disease can lead to an irreparable, unexpected and dangerous outcome. Swelling of the brain can occur in every person and for many reasons.

For example, in severe toxicosis during gestation, hypoxia may develop in the mother and fetus, which can later cause swelling of the child's brain.

A number of specific factors can cause brain pathology in newborns, namely:

Getting a head injury during.
Long difficult labor.
Intrauterine oxygen starvation.
Infections received in the womb.
Infection during childbirth.
Congenital oncology of the brain.

You can suspect a pathology in a baby based on the following symptoms:

The child is very restless.
Intense bursting cry.
Refusal of food.
Sleepy state.
Slowdown in movement.
Enlargement of a large fontanelle.
Vomit.
Seizures.

In children, cerebral edema develops very quickly. The symptoms progress and increase, the baby's condition worsens. Often the resulting brain injuries are not subject to reverse development, and the child may die. Therefore, treatment should begin as soon as possible.

When treating newborns, doctors try not to resort to surgical intervention, because such a procedure can, with a high probability, end in the death of a small patient.

In the treatment of edema in children, drugs are used that remove fluid from the body, inhibit the development of edema, eliminate convulsions and normalize blood supply. In some cases, resort to artificial lowering of the body.

The consequences after suffering cerebral edema in children are very diverse. Often, parents of such children notice a developmental delay, impaired motor skills, speech, intellectual and physical abilities. In some cases, children develop or epilepsy.

After a long and successful treatment, the child will be registered with a pediatrician and a neurologist for a long time. In case of developmental delay or speech delay, the baby is additionally prescribed regular visits to a psychiatrist.

Planning for pregnancy should begin with a consultation with a gynecologist. He will determine the presence of possible infections or viruses and prescribe proper treatment. The absence of health problems in the mother is a guarantee of the birth of a healthy baby.

Cerebral edema is a dangerous condition that requires immediate assistance to the affected patient!

Cerebral edema, the causes and consequences of which we will consider in this article, is the body's reaction to excessive stress, injury and infection. As a rule, this process occurs quite quickly. At the same time, the cells themselves and the space between them are filled with an excess amount of fluid, and as a result, the brain increases in volume, which, in turn, causes an increase in intracranial pressure, deterioration of cerebral circulation and leads to cell death.

Such a condition, as you understand, requires mandatory and urgent medical care in order to avoid serious consequences and death.

Causes of edema

Causes of cerebral edema may be different and lie, for example, in violation of cerebral circulation, expressed by ischemic or hemorrhagic stroke, in traumatic brain injury, in the presence of an intracranial cancerous tumor or metastases from tumors of any localization.

Inflammatory processes in the brain or its membrane (meningitis or encephalitis), fractures of the cranial vault with damage to the medulla, as well as general diseases in the form of severe infections, cardiovascular pathologies, or extensive burns can also cause cerebral edema.

In addition, even a strong allergic reaction in the stage of anaphylactic shock or drug and alcohol intoxication can provoke the development of this pathology.

What is the main danger of edema

Swelling of any tissues in the human body is a fairly common and quite natural phenomenon, which, as a rule, disappears without any special consequences. But the brain is in a limited space, in a dense cranium, which cannot increase its volume under the pressure of its tissues.

Whatever the causes of cerebral edema, they ultimately lead to the fact that there is a compression of its substance in a narrow space. And this circumstance entails the greatest danger: the ischemia of neurons is aggravated, the progression of edema intensifies, and at some point brain functions are lost.

Cerebral edema in stroke: what causes it

One of the common causes of the mentioned edema in a patient is hemorrhagic or unfortunately, these types of circulatory disorders are almost always accompanied by the described problem, expressed to one degree or another and being a kind of indicator of the severity of the pathological process.

Causes of cerebral edema in newborns

Separately, it is worth considering this pathology in newly born children. The causes of cerebral edema in them most often lie in the difficult course of childbirth in the mother and the birth trauma of the baby. But it can also be provoked by congenital malformations or acquired diseases. Abscesses, tumors, intrauterine hypoxia - all this can cause cerebral edema in infants.

By the way, the course of the described pathology in children looks somewhat different than in adults, since their body is still very limited in its ability to maintain vascular tone, regulate intracranial pressure and liquorodynamics. The only salvation of the child in such a situation lies in the features of the connection of the bones of the skull, between which he has either soft cartilage tissue or a gap (fontanelles). By the way, this anatomical feature protects the baby from compression and swelling of the brain, which could end in any cry of the crumbs.

Features of the symptoms of cerebral edema in infants

Cerebral edema in newborns is characterized by a fulminant course. At the beginning of the development of pathology, the baby, as a rule, becomes lethargic, sleepy, he may experience convulsions, and his consciousness will turn off. In some children, on the contrary, the edema causes an excited state, expressed by constant non-stop crying.

At the same time, the fontanel swells even in a calm state, the volume of the head increases, the baby has vomiting, and the temperature rises.

In newborns with cerebral edema, a characteristic feature of this pathology is a very rapid deterioration in the general condition and, unfortunately, in many cases it ends in death.

Cerebral edema: consequences

The sooner a patient with this diagnosis is provided with qualified medical care in full, the higher his chances of recovery. But quite often, recovery is only partial - it all depends on the severity of the pathological process.

The consequence is sometimes, for example, the development of epilepsy, caused by a violation of the blood supply to certain parts of the brain. The patient may have increased intracranial pressure, leading, in turn, to dizziness, mental disorders, and even to a decrease in social communication skills.

In many patients diagnosed with cerebral edema, the consequences of the pathology are manifested in the adhesive process in its ventricles, between the membranes or in the liquor space, which leads not only to periodic headaches, but also to a depressive state and a disorder of neuropsychic activity.

If the edema was prolonged, then its consequence may be a violation of the functions of the brain and a decrease in the mental abilities of a person.

How are the consequences of cerebral edema in children

The consequences of the disease in question in children can also be serious and depend on the severity of the course of the disease.

These include the development of cerebral palsy and hydrocephalus, epilepsy, as well as violations of the formation of internal organs.

Cerebral edema in some children can cause problems with speech, as well as with coordination of movement. The transferred pathology, unfortunately, causes neuropsychic instability and mental retardation in some patients.

From the foregoing, it is clear that cerebral edema in children is a very serious pathology that requires constant monitoring of the child by a neuropathologist and pediatrician, and its duration depends on the severity of the consequences of the disease.

Cerebral edema is a nonspecific pathological increase in the volume of brain tissue due to an increase in the content of fluid in it. It is not an independent disease and occurs as a result of various pathological conditions of an exogenous or endogenous nature. Cerebral edema is a potentially life-threatening complication, which is explained by the risk of critical compression of nerve structures in natural foramens or protrusions of the skull.

Etiology

Cerebral edema may be the result of damage to nerve cells or severe metabolic disorders. Its main reasons include:

open and closed, including operations;
leading to toxic or direct (with neuroinfections) damage to the nervous tissue;
causing displacement of brain structures or impaired outflow of cerebrospinal fluid;
embolism of cerebral vessels with development, as an embolus, blood clots, crumbling atherosclerotic plaques, gas bubbles can act;
, subarachnoid hemorrhage;
poisoning with neurotoxic poisons and some drugs;
eclampsia;
radiation exposure;
metabolic encephalopathy, the most common causes of its development are renal liver failure, diabetes mellitus,;
water intoxication, a condition after drowning in fresh water.

In children born prematurely or as a result of pathological births, cerebral edema is predominantly traumatic.

Toxic cerebral edema can be caused by exposure to phenols, alcohols, acetone, gasoline (and other refined products), organophosphorus compounds, cyanides, turpentine, and a number of other substances. Of the drugs, tranquilizers, tricyclics, atropine, quinine derivatives, and antihistamines have a neurotoxic effect in case of overdose. Some drugs initially lead to cardiovascular disorders, which affects the functioning of the brain and thereby contributes to the development of its edema.

Pathogenesis

With cerebral edema, an excess amount of fluid can accumulate in the intercellular space or in the cytoplasm of neurons. In the latter case, they speak of swelling of the brain tissue. Both of these conditions lead to an increase in brain volume and impaired functioning and usually coexist with each other.

Currently, there are 4 main mechanisms for the development of cerebral edema: vasogenic, cytotoxic, osmotic, hydrostatic. Their formation depends on the cause of damage to the nervous tissue. With the progression of edema, others begin to connect to the primary pathogenetic mechanism, which aggravates the existing disorders. Any form of cerebral edema leads to an increase in intracranial pressure due to a decrease in the space between the pia mater and dura mater.

Vasogenic edema occurs due to increased permeability of capillary walls and a prolonged increase in pressure inside the vessels of the brain. This contributes to an increase in plasma filtration, a disruption in the functioning of the blood-brain barrier, and the subsequent spread of fluid through the intercellular spaces. Vasogenic edema is more pronounced in the white matter of the brain, which is looser in structure compared to the cortex.

The osmotic mechanism of edema often accompanies the vasogenic one, it is due to the pathological osmotic gradient between plasma and intercellular fluid. Hyperosmolarity of brain tissue is noted in decompensated metabolic encephalopathy, renal and hepatic insufficiency, and hyperglycemia.

Cytotoxic edema is an intracellular accumulation of fluid due to disruption of the ion pumps of cell membranes in conditions of ATP deficiency. It is this mechanism that leads to swelling of the brain. Glial perivascular cells are primarily affected, then the process also captures the bodies of neurons.

Hydrostatic cerebral edema is caused by a rapid excess pressure increase in the ventricular system of the brain. Most often this is caused by a significant violation of the outflow of cerebrospinal fluid while maintaining its production.

Symptoms

Headache caused by cerebral edema torments the patient and is not relieved by taking analgesics.

Symptoms of cerebral edema consist of manifestations of increased intracranial pressure and local neurological disorders due to compression of certain brain structures.

Main symptoms:

bursting, pressing, diffuse headache that is not stopped by taking analgesics;
feeling of pressure on the eyeballs and ears, blurred vision and hearing;
vomiting that is not associated with food intake and does not bring relief;
a change in the depth of consciousness, because of which a person looks confused, slowed down, is not clearly oriented in time and space, with an increase in edema, stupor and coma develop sequentially;
short-term episodes of loss of consciousness are not excluded;
it is possible to develop a convulsive syndrome, which is most often associated with irritation of the motor areas of the cerebral cortex;
diffuse muscle hypotension;
the appearance and growth of focal neurological symptoms, pathological stem reflexes;
psychotic disorders, the most typical visual hallucinosis and psychomotor agitation against the background of confusion.

The addition of new symptoms, a progressive decrease in the level of consciousness indicate an aggravation of cerebral edema. This is a life-threatening condition and requires intensive therapy to eliminate the cause and correct metabolic disorders.

What is the danger of cerebral edema

The most formidable complication of cerebral edema is the development of dislocation syndrome. Lateral or axial displacement of the brain structures leads to their wedging into the foramen magnum or under the outgrowths of the dura mater (under the cerebellar tenon or falciform process). In this case, there is an infringement of various parts of the cerebellum, brain stem, medial parts of the parietal and frontal lobes, basal parts of the temporal lobe.

The most formidable signs of dislocation syndrome are a violation of the rhythm of breathing and heartbeat, a significant persistent decrease in blood pressure, floating movements of the eyeballs, bulbar disorders and severe pyramidal insufficiency. And the development of occlusive crises leads to cardiac and respiratory arrest.

Long-term consequences of severe cerebral edema may be cognitive impairment and preserved neurological symptoms.

Research Institute of Neurosurgery. N. N. Burdenko, video presentation on the topic "Variants of cerebral edema":

Cerebral edema is a pathological syndrome characterized by the accumulation of a larger than normal volume of fluid in the brain (cells or intercellular space).

Since the cranial cavity is limited by rigid structures, the swollen brain has to “shrink” in the same amount of space provided. Due to this, cells and intracellular structures that provide energy metabolism are compressed. Metabolism is disturbed, and brain tissue ceases to function normally.

According to pathogenesis, they are distinguished:

Cytotoxic edema: Fluid accumulates predominantly in cells. Among the etiological factors is a violation of the supply of energy substrates to the brain cells. Due to this, membrane ion pumps stop working. The cells accumulate a large amount of Na + ions. Since these are osmotically active particles, they also retain water in the cells. Astroglial cells are predominantly affected. Moreover, the bodies of astrocytes "swell" only after the "swelling" of the processes, at the very last stages;

Vasogenic edema characterized by increased vascular permeability of the blood-brain barrier. In view of this, various osmotically active particles penetrate the barrier, which then entrain the liquid;

Interstitial edema develops in case of hyperproduction of cerebrospinal fluid. First of all, the pressure in the ventricles of the brain increases, then impregnation of the adjacent tissues may occur.

Cerebral edema can develop with traumatic brain injury, brain tumors, cerebral embolism, toxic damage to the body (alcohol, alcohol surrogates, poisons, drug overdose), with eclampsia, with severe renal or hepatic insufficiency, in cases of acidosis (ketoacidosis, lactate - acidosis), with prolonged hypoxia of any origin, with infectious diseases, with circulatory disorders of the brain, sometimes with prolonged convulsive syndrome.

Clinical picture

There are 3 groups of symptoms:

Syndrome of intracranial hypertension(develops due to the fact that "the swollen brain does not fit in the cranium") - bursting intense headache, nausea, vomiting (due to irritation of the trigger zone of the vomiting center). A distinctive feature is that vomiting does not bring relief, as in the case of gastrointestinal pathology. Decreased level of consciousness. The classic picture in stroke is Cushing's triad: bradycardia against the background of high blood pressure + decreased breathing.
Focal symptoms- develop when the zone (center) responsible for certain functions (speech, limb movements, vision ...) suffers.
stem symptoms- their development translates the course of the disease into a critical stage. Due to the general increase in the volume of the brain, he is "trying to find a way out" of the cranium and take up free space. The “exit” is located in the area of the foramen magnum, in which the brain stem passes. With (dislocation) displacement of stem structures, the functioning of the centers responsible for vital functions - blood circulation and respiration - is disrupted. Thus, respiratory arrest (the need for artificial ventilation) and blood circulation (various types of rhythm disturbances with inefficient blood circulation) can occur.

Treatment

Since the supply of nutrients depends on the central perfusion pressure, the main goal of the treatment of cerebral edema will be to maintain it at the proper level.

Central perfusion pressure is defined as arterial pressure minus central venous pressure and . Since intracranial pressure is increased in cerebral edema, the resulting central perfusion pressure will be less than necessary.

Therefore, the primary goal is to reduce intracranial hypertension by all available means:

Ensuring complete rest, if necessary - sedation (introduction of drugs that suppress arousal, motor activity).
Elimination of pain (pain provokes arousal, even if it is not manifested by physical activity).
Elimination of the causes that violate the general venous outflow from the brain (tight bandages in the neck, lowered head end of the bed).
Maintenance of normal body temperature (in case of violations in the area of the thermoregulation center, it will increase, and the drugs that work with fever of inflammatory origin are usually inactive here, physical cooling helps more).
Ensuring adequate oxygenation (up to transfer to a ventilator if necessary).
the appointment of diuretics (removal of fluid from the body).

In the case of cytotoxic edema, it is recommended to maintain high blood pressure (it is necessary to "push" nutrients into swollen cells, which are more eager to "push" something than to take in). Also, it is here that more than with other types, it is shown osmodiuretic mannitol. As noted above, with cytotoxic edema, osmoactive particles accumulate in the cells and attract fluid.

With the introduction of mannitol, the osmoactive substance in the blood will compete with intracellular osmotic particles for fluid. In the case of vasogenic edema, mannitol enters the cells through vessels with increased permeability and can only aggravate the condition.

With vasogenic cerebral edema, it is illogical to maintain high blood pressure, because. this will only provoke the leakage of even more fluid through vessels with increased permeability. In this case, it is worth focusing on the hydrostatic pressure gradient between the media. With vasogenic, more than with cytotoxic, cerebral edema, glucocorticoids are effective, which reduce vascular permeability.

With the ineffectiveness of all the re-segmented methods of conservative therapy, decompression craniotomy is performed. The point is to give extra space beyond the closed cranium until the situation can be corrected by other methods.

Consequences of cerebral edema

Even with a favorable outcome, cerebral edema does not pass without a trace. Patients may be disturbed for a long time by headaches, mood lability, impaired concentration. If, as a result of diseases that accompany cerebral edema (for example, a stroke), a certain part of the brain responsible for some functions dies off, then they may fall out or be disturbed.

If these are centers that provide movement, then paralysis and paresis develop, in severe cases, swallowing disorders may develop. Cognitive impairment may also occur. Areas of the brain with impaired blood supply during edema can become epileptogenic foci. In children, cerebral palsy can become a consequence of edema at an early age. But, of course, the most unfavorable consequence (with increasing edema) is herniation with the development of a violation of vital functions and death.