Causes and symptoms of cerebral edema. Clinical manifestations of cerebral edema Diffuse cerebral edema consequences

Brain edema is a consequence of interrelated physical and biochemical processes occurring in the body as a result of diseases or pathological conditions.

This complication, depending on the severity, may remain unnoticeable and pass without a trace, for example, with a mild one). Much more often, the consequences of cerebral edema are further severe complications in the form of:

• changes in mental and mental activity
• visual impairment
• auditory
• motor
• coordination functions of the body that are the cause of disability
• Often cerebral edema ends in death.

What is cerebral edema

The essence of the accepted definition of this condition is a nonspecific reaction of the whole organism in response to the influence of severe damaging factors. The latter are the reason:

• disorders of blood microcirculation in brain tissue;
• lack of oxygen transport to the brain, especially in combination with excessive accumulation of carbon dioxide in the blood;
• disturbances of water-electrolyte, protein and energy metabolism with accumulation of lactic acid in nerve cells;
• violations of the acid-base state of the blood;
• changes in osmotic (electrolyte) and oncotic (protein) pressure of plasma.

All these reasons lead to swelling and swelling of the brain. With edema, the permeability of the capillary walls is impaired and the liquid part of the blood leaks into the surrounding tissues. During swelling, due to the difference in oncotic pressure, water molecules enter directly into the nerve cells of the brain through their membrane. Here they are bound by intracellular proteins and the cells increase in volume.

However, most authors of scientific articles consider swelling as one of the stages of edema, leading to a volumetric increase in the brain. This leads to its compression and displacement (dislocation) around its axis inside a closed space limited by the bones of the skull.

The spread of cerebral edema causes compression of the underlying structures (medulla oblongata) in the foramen magnum. It contains vital centers - breathing regulation, cardiovascular activity and a thermoregulation center.

Signs of cerebral edema are clinically manifested in disruption of the functioning of nerve cells and brain centers even before complete damage to their structures occurs, which can already be determined using modern research methods.

Types and causes of edema

There are two types of cerebral edema:

1. Local or regional edema, that is, limited to a certain area surrounding a pathological formation in the brain tissue - an abscess, tumor, hematoma, cyst.
2. Generalized, widespread throughout the brain. It develops with traumatic brain injury, suffocation, drowning, intoxication, loss of large amounts of protein in the urine due to various diseases or poisoning, with hypertensive encephalopathy resulting from severe forms of high blood pressure, and other disorders.

In many cases, with the exception of traumatic brain injury or asphyxia (suffocation), identifying cerebral edema can be difficult against the background of symptoms of other diseases and pathological conditions. The onset of the development of edema can be assumed when the signs of the underlying disease decrease or do not progress, but neurological symptoms, on the contrary, appear and increase.

The main causes of cerebral edema:

• traumatic brain injury, concussion and contusion of the brain, asphyxia with vomit during an alcoholic coma or after hanging, laryngeal stenosis in children with acute respiratory infection (see);
• subdural hematoma, formed under the dura mater as a result of mechanical impact without violating the integrity of the bones of the skull;
• brain tumors, subarachnoid (under the arachnoid mater)
• hemorrhage, which often occurs as a result of a stroke with high blood pressure (see,;
• acute infectious diseases - influenza, meningitis, encephalitis, including severe childhood infections - measles, scarlet fever, chicken pox;
• gestosis in the second half of pregnancy - severe nephropathy, preeclampsia and eclampsia;
• diseases accompanied by convulsive syndrome - hyperthermia in children (high temperature) with infectious diseases, heat stroke, epilepsy;
• severe diabetes mellitus, especially occurring with episodes of hypoglycemic state, acute and chronic renal, hepatic or renal-hepatic failure;
• severe allergic reactions and anaphylactic shock;
• poisoning with medications, chemical poisons and gases;
• cerebral edema in newborns as a result of entanglement in the umbilical cord, protracted labor, severe gestosis in the mother (see), birth injury to the child’s brain.

In addition, swelling of the brain almost always occurs after cranial surgery. Sometimes - after operations performed under spinal or epidural anesthesia or accompanied by large blood loss, due to a pronounced and prolonged decrease in blood pressure, with excessive intravenous administration of saline or hypotonic solutions during surgery, due to the difficulty of tracheal intubation for the purpose of artificial ventilation or inadequacy of ventilation itself and anesthesia.

Symptoms of cerebral edema

Depending on the duration of the disease, the localization of the lesion, the prevalence and rate of growth of the process, the symptoms of cerebral edema may be different. Local, limited edema is manifested by general cerebral symptoms or single signs characteristic of a given part of the brain. With increasing or initially generalized edema, but slowly increasing, there is also a gradual increase in the number of symptoms, indicating damage to several parts of the brain. All symptoms are divided into three groups:

Signs of increased intracranial pressure

• headache
• drowsiness and lethargy
• sometimes alternating with psychomotor agitation
• depression of consciousness gradually increases, and nausea and vomiting appear
• dangerous convulsions are clonic (short-term, sweeping contractions of the muscles of the limbs and face), tonic (prolonged muscle contractions, giving individual parts of the body an unusual position) and clonic-tonic, leading to an increase in cerebral edema.
• A rapid increase in intracranial pressure causes a bursting headache, repeated vomiting, and disturbance in the movement of the eyeballs.
• Swelling of the brain in children (in infants), children under 1 year of age leads to an increase in head circumference (see), and after the fontanelles close, to their opening due to displacement of the bones.

The appearance of diffuse (scattered) neurological symptoms

This is a reflection of the increase in the pathological process, which carries the risk of developing coma due to cerebral edema. This is caused by the involvement of the cerebral cortex first in the edema, and then the subcortical structures. In addition to impaired consciousness and transition to a coma, the following occur:

• generalized (widespread) repeated seizures
• psychomotor agitation between attacks of epileptic seizures, occurring with a predominance of increased muscle tone
• pathological defensive and grasping reflexes

Group of the most dangerous symptoms

They are associated with a further increase in cerebral edema, dislocation (displacement) of its structures, with their wedging and pinching in the foramen magnum. These signs include:

• Coma of varying degrees.
• Hyperthermia (up to 40 degrees or more), which cannot be reduced with the use of antipyretic and vasodilating drugs. Sometimes it is possible to slightly reduce the temperature only by using cold in the area of ​​​​large vessels or general hypothermia.
• There are different sizes of pupils and their lack of reaction to light, strabismus, “floating” eyeballs, unilateral paresis and unilateral convulsive contractions of the extensor muscles, heart rhythm disturbances with a tendency to decrease the heart rate, and the absence of pain and tendon reflexes.
• If the patient is not given artificial ventilation, the frequency and depth of breathing initially increases, the breathing rhythm is disturbed, followed by a stop and cessation of cardiac activity.

Diagnostics

In an outpatient setting, diagnosing cerebral edema is quite difficult, since this condition does not have any special, specific neurological symptoms. In the early stages, cerebral edema may be mild or asymptomatic. The diagnosis is made based on the symptoms of the underlying disease or injury that caused the swelling, as well as the results of a fundus examination.

If the development of cerebral edema is suspected, the patient should be taken to the intensive care unit or neurosurgical department. In a hospital setting, the issue of performing a lumbar puncture and angiography is decided. MRI and CT are informative, which help to identify edema, assess the degree of its severity and prevalence.

Consequences of cerebral edema in adults and children

The sooner such a pathology is detected and intensive and adequate medical care is provided, the higher the chances of recovery. In a hospital setting, the blood supply to the brain, cerebrospinal fluid dynamics, and dehydration therapy are restored; the prognosis is largely determined by the severity of the disease.

Because with minor perifocal edema, complete recovery is possible, but with the development of cystic-atrophic processes in the brain tissue, only partial restoration of functions can be achieved. When only the underlying disease, accompanied by cerebral edema, is treated, recovery is not possible in all cases and the risk of death is high.

The success of treatment and consequences depend on the severity of the disease that caused cerebral edema and the degree of development of the edema itself, which can resolve with complete recovery. In more severe cases, there are:

• When edema develops in the medulla oblongata, where the main life support centers of the body are located, the consequences of cerebral edema can be respiratory failure, convulsions, epilepsy, and impaired blood supply.
• Even after treatment, the patient may continue to have pain, which greatly worsens the patient’s quality of life, as it is accompanied by headaches, confusion, loss of orientation in time, decreased social communication skills, lethargy, and drowsiness.
• Infringement of the brain stem, as well as its displacement, is very dangerous; this threatens respiratory arrest and the development of paralysis.
• After treatment and a course of rehabilitation, many patients are left with adhesions between the membranes of the brain, in the ventricles of the brain or in the cerebrospinal fluid spaces, which is also accompanied by headaches, disorders of neuropsychic activity and depressive states.
• With prolonged cerebral edema without treatment, brain dysfunction may subsequently appear and a person’s mental abilities may decrease.

In children, complete recovery is also possible or:

• development of cerebral palsy and hydrocephalus (see)
• epilepsy (see) and dysfunction of internal organs
• speech and motor coordination disorders
• neuropsychic instability and mental retardation

Cerebral edema is a serious, often very severe pathology that requires further observation and treatment of adults by a neurologist, psychoneurologist, and children by a neurologist together with a pediatrician. The duration of observation and treatment after cerebral edema depends on the severity of residual effects.

The brain is responsible for the functioning of all organs and systems, so disruption of its functioning invariably causes serious problems in the body. Cerebral edema is the human body's response to infection or overuse. This condition develops in a short time and can disappear just as quickly if the necessary measures are taken in time. If the cause of this condition lies in a traumatic injury or serious illness, then getting rid of it is much more difficult.

The essence of the disease

This pathology is nothing more than the body’s reaction to damaging factors. This could be due to an infectious disease, traumatic injury, or overuse.

During the development of edema, the cells and intercellular space of the brain are rapidly filled with a large amount of fluid. This causes an increase in brain volume, which invariably leads to an increase in intracranial pressure.

As a result, blood circulation deteriorates and brain cells die. This pathology often occurs in children.

In children, factors such as:

• traumatic brain injuries;

Newborn children may suffer from this pathology due to hypoxia, maternal diseases, toxicosis during pregnancy, and injuries during childbirth.

Types and classification

Depending on the origin, four main types of edema can be distinguished:

• Vasogenic edema. This pathology involves a breakdown of the blood-brain barrier, which causes the penetration of plasma proteins. It is often observed with brain tumors.
• Cytotoxic edema. Its development is caused by disturbances in osmoregulation of cell membranes. Their permeability causes excessive swelling of the white matter. This type of cerebral edema is usually observed with skull injuries.
• Ischemic edema. It assumes the action of the listed mechanisms, but they progress in stages. An example would be a cerebral hemorrhage. This swelling most often occurs during or after a stroke.
• Interstitial edema. In this situation, the brain tissue becomes saturated with excessive amounts of cerebrospinal fluid. This condition is characteristic of hydrocephalus.

Depending on the factor in the development of edema, the following types of pathology can be distinguished:

• postoperative (usually such swelling occurs as a consequence of complications after surgery);
• post-traumatic (occurs after injury and is characterized by swelling of the brain);
• toxic (this type of cerebral edema can develop, for example, due to alcoholism or poisoning with toxic substances);
• tumor (it is not uncommon for the patient to die from this type of edema, because it affects large areas of the brain);
• inflammatory (occurs after an inflammatory process);
• epileptic (swelling due to epilepsy);
• ischemic (usually develops after a stroke or hemorrhage);
• hypertensive;
• neuroendocrine.

If we talk about the size of brain damage, then swelling can be:

• Local – located in the area of ​​the lesion.
• Diffuse - localized in one hemisphere.
• Generalized – observed in two hemispheres.

The location of the edema determines the following types of pathology:

• Brainstem swelling. An extremely dangerous condition that is associated with a disorder of vital functions - breathing, blood circulation, etc.
• Edema of cerebral vessels.
• Swelling of the brain substance.

Edema that develops as a result of hypoxia, tumors, and inflammation must be differentiated from perifocal edema - it is swelling of the brain in the area of ​​cell destruction. This pathology develops with traumatic injuries.

In accordance with ICD-10, this disease is coded under the code G00-G99 “Diseases of the nervous system”, G90-G99 “Other disorders of the nervous system”, G93.6 “Cerebral edema”.

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Causes of cerebral edema

The development of edema can be caused by illness, infection, traumatic injury, and sometimes even a change in altitude. The most common causes of this pathology are:

• Traumatic brain damage. This is mechanical damage to the structure of the skull. It is often complicated due to the fact that the brain is injured by bone fragments. Severe swelling prevents fluid from leaking out of the brain tissue.
• . A common pathology associated with abnormalities of cerebral circulation. Brain cells do not receive enough oxygen, and therefore they begin to die, which leads to the development of edema.
• Hemorrhagic stroke. Associated with damage to cerebral blood vessels. Hemorrhage causes an increase in intracranial pressure.
• Infections:

  - subdural abscess;

  - toxoplasmosis.

• Tumors. During the development of such a formation, compression of an area of ​​the brain occurs, which leads to poor circulation and swelling.
• Height difference. There is information according to which an altitude of one and a half kilometers above sea level can cause cerebral edema.

Symptoms and signs

Symptoms increase as intracranial pressure increases.

If the swelling progresses, brain structures may shift and become wedged into the foramen magnum.

Sometimes focal symptoms are observed: paralysis and paresis of the oculomotor nerve, as a result of which dilated pupils are diagnosed.

In the early stages, you may notice the following signs:

• , which often have a bursting character.
• Loss of orientation in time and space.
• Sense of anxiety.
• Nausea and vomiting with high-intensity headaches.
• Stun.
• Drowsiness.
• Constriction of the pupils.
• Breathing problems.
• Increased pressure.
• Arrhythmia.

In some cases, vision completely disappears - this occurs if there is compression of the posterior artery of the brain.

Also, as the pathology progresses, coordination of movements is impaired, swallowing disorder occurs, severe vomiting, neck stiffness, cyanosis are observed, and tendon reflexes fade.

Sometimes a person loses consciousness and convulsions may occur. In the most difficult situations, a person falls into a coma.

Diagnostics

CT photo of cerebral edema

To make a correct diagnosis, a set of procedures should be performed:

• Analysis of anamnesis. The doctor clarifies complaints and analyzes the reasons that could cause this condition.
• Neurological examination. At this stage, the level of consciousness and symptoms that indicate neurological disorders are assessed.
• Fundus examination. This condition is characterized by swelling of the optic nerve.
• Lumbar puncture. A puncture is performed in the lumbar region to determine the increase in intracranial pressure.
• Computer and. With these procedures, signs of edema can be assessed.
• Measuring intracranial pressure. For this purpose, a special sensor is inserted into the cavity of the ventricles of the brain.

First aid

If cerebral edema is observed, the patient must be given first aid.

It includes the following activities:

• Local hypothermia. To do this, the person's head should be covered with ice packs.
• Intravenous administration of 20-40 ml of glucose (40%).
• Administration of glucocorticoids - dexamethasone (6-8 ml), prednisolone (30-60 mg).
• Administration of Lasix in saline solution – 20-40 ml.
• Oxygen inhalation.
• Administration of piracetam solution intravenously – 10-20 ml.

After first aid is provided, the person is placed in a neurological hospital. If there has been a skull injury, he is admitted to the neurosurgical department.

In case of toxic cerebral edema, especially in the case of coma, the person is hospitalized in the toxicology department or intensive care unit.

It is not possible to relieve cerebral edema on your own, so you must seek medical help.

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Treatment of cerebral edema

There are situations when all signs of illness disappear on their own - this applies to some forms of mountain sickness or mild concussion.

Other cases require immediate medical attention. Only a specialist can decide how to treat cerebral edema, taking into account all the features of the pathology.

Therapy should be aimed at restoring oxygen metabolism in brain cells. This can be achieved through a combination of drug and surgical treatment methods. Thanks to such measures, it is possible to relieve cerebral edema and avoid dangerous health consequences:

• Oxygen therapy. This procedure involves introducing oxygen into the airways. This is done through the use of an inhaler or other equipment. Thanks to this, the nutrition of the brain improves, which reduces recovery time.
• Hypothermia. Involves a decrease in body temperature. Despite the fact that this method perfectly corrects cerebral edema, today it is not used very often.
• Intravenous infusion. With this procedure, it is possible to maintain normal blood pressure, blood flow and fight infections.
• Ventriculostomy. Helps reduce intracranial pressure. It involves draining excess fluid through a special catheter.
• The choice of medications is made depending on the cause that caused the development of edema.

In particularly difficult cases, surgical intervention is prescribed. During decompensated craniectomy, it is possible to remove part of the skull bone, which reduces intracranial pressure.

Also, during the operation, the cause that caused this pathology can be eliminated. If necessary, the tumor is removed or the damaged blood vessel is restored.

Folk remedies can also help with swelling, but they can only be used after consulting a doctor:

• White mistletoe decoction. It is used for the development of formation in the brain. To prepare it you need to take 200 grams of milk and 3 grams of dried mistletoe flowers. The dose must be selected by the doctor.
• Propolis tincture. For 1 gram of propolis you need to take 10 grams of alcohol. Pour alcohol into the propolis and leave until completely dissolved, then strain. Take a teaspoon before meals. This should be done three times a day.

Consequences and prognosis

The consequences of the development of this pathology depend on the severity of brain damage.

Conditions such as:

• Depression.
• Absent-mindedness.
• Impaired physical activity.
• Constant headaches.
• Impaired communication abilities.

The course and consequences of the disease are largely influenced by the adequacy and timeliness of treatment. During edema, pressure is observed on brain structures, which can lead to disruption of the heart and respiratory organs.

Lack of oxygen causes brain cell death. As a result, paralysis of the body may occur. In especially severe cases, the person falls into a coma. If vital parts of the brain are affected, then death occurs.

Cerebral edema is a dangerous disorder that, if not properly treated, can cause serious health consequences. Therefore, it is very important to immediately seek help from a doctor - thanks to this you can save not only your health, but also your life.

Cerebral edema (CE) is a dangerous complication that progresses due to the development of certain cranial diseases. This abnormal process is characterized by an immense accumulation of intracellular fluid in brain cells. That is, decompensated microcirculatory disorders of the internal structures of the organ occur.

When there are actively developing focal pathological lesions in the brain, which are extremely difficult to treat, the function of self-regulation of vascular tone begins to work incorrectly, which causes rapid dilation of blood vessels. Diffuse swelling of cerebral vessels instantly spreads to healthy areas and initiates an increase in pressure in them.

These pathological modifications end in the fact that the vascular walls lose their usefulness and are unable to retain the watery components of the blood, which, under the influence of high pressure, leak through them into the brain tissue. The internal structures of the brain are gradually saturated with blood fluid, and each cell of the organ increases several times.

Since the brain space is limited by the intracranial cavity, such deformations cause metabolic dysfunction, as well as complete/fragmentary disruption of the functioning of the brain.

The patient experiences a disorder of consciousness, and overall health deteriorates sharply. If you do not provide the patient with prompt and adequate medical care, the GM will completely cease to function, which in turn can lead to death.

Cerebral edema - classification

Depending on the etiology of the pathological course, there are four main types of cervical edema:

Vasogenic cerebral edema

Usually develops as a result of traumatic brain injuries, encephalitis, with incorrect blood microcirculation, various formations (cancerous/benign) in the structure of the organ, hemorrhagic strokes, etc. It is characterized by high capillary permeability and BBB dysfunction, due to which vascular fluid penetrates beyond the boundaries of the walls and fills the white matter.

Cytotoxic

Formed during head injury, hypoxia and ischemia of the brain. Cytotoxic edema develops rapidly and is localized in the gray matter of the brain. This type is characterized by swelling of neurons, glia and endothelial cells. The activity of the cell membrane is disrupted, sodium accumulates in large quantities in the brain cells and, under the influence of osmotic pressure, water penetrates into the internal space of the cellular structures.

Interstitial

Occurs with hydrocephalus, otherwise this disease is called “dropsy”. The normal outflow of cerebrospinal fluid in the ventricles is disrupted, and therefore their activity increases and internal pressure increases. Under the influence of the latter, excessive filtration occurs, accumulation of fluid and low molecular weight substances in the brain.

Osmotic

Abnormal changes affect the osmotic vector between the osmolarity of blood plasma and the osmolarity of brain tissue. Osmotic edema of the brain is especially pronounced in patients with acute organ damage and patients with renal failure.

Causes of cerebral edema

The key factors that act as sources of the painful condition include:

1. TBI – mechanical damage to the bone and tissue structures of the brain leads to the formation of intracranial hematomas, swelling, which prevents the release of accumulated fluid outside the brain tissue.
   Ischemic stroke - occurs when cerebral circulation is impaired. Almost no oxygen enters the organ cells, and they gradually begin to die.
2. Hemorrhagic stroke.
3. Infections – mumps, influenza, measles, encephalitis, meningitis, etc.
4. Malignant tumors.
5. Changes in altitude - scientists have found that at an altitude of 1.5 kilometers above sea level, swelling of the brain can develop (this means a rapid increase in altitude without the body getting used to it).
6. Intoxications of an endogenous nature, formed as a result of severe diabetes mellitus, liver dysfunction, acute renal failure.
7. Poisoning with drugs/poisons.
8. Alcoholism.
9. Allergies – Quincke's edema, anaphylactic shock.
10. In infants, the cause of cervical edema can be severe toxicosis in a pregnant woman during gestation, hypoxia, or skull injuries received during childbirth.
11. Brain swelling after stroke

GM swelling after stroke

This is an almost inevitable phenomenon. Most often, pathology occurs in the presence of tumors in the brain. Characterized by the accumulation of fluid in nerve cells. The following signs may indicate the formation of swelling of the brain after a stroke:

• sharp pain in the head;
• causeless vomiting;
• dysfunction of the visual apparatus or partial loss of functions of other senses;
• disorientation in space;
• rapid breathing, palpitations, shortness of breath;
• stupors;
• cramps in the limbs;
• fragmented memory loss;
• dizziness;
• periodic loss of consciousness.

The last symptom is extremely dangerous with swelling of the brain, as it can provoke coma.

Swelling of the GM after surgery

Occurs as a consequence of postoperative complications. Usually appears within 24 to 72 hours after surgery on the organ. Rapid development, failure of preventive measures after surgery and diagnostic problems can provoke coma.

In order to prevent the formation of edema, the patient must be given corticosteroids and fluid drainage in the first three days.

Alcoholic cerebral edema

Long-term consumption of alcohol-containing drinks over time leads to the destruction of brain cells and the formation of edema. In addition to the symptoms characteristic of the disease, the patient’s physique is noticeably different (large belly, thin arms/legs), and he periodically sees visual hallucinations. There is persistent swelling on the face, the skin peels and has a pronounced bluish tint.

GM swelling due to allergies

Allergic swelling of the brain can be caused by various factors (taking certain medications, eating highly allergenic foods, insect bites, etc.). With this type of pathology, the patient’s condition instantly (within several hours) worsens, and phenomena such as:

1. headache;
2. fear of light and sound;
3. numbness of the occipital region (with this condition it is impossible to press the chin to the chest);
4. vision and speech deteriorate;
5. nausea, in rare cases vomiting is possible;
6. numbness of arms and legs;
7. paralysis.

Symptoms

Symptoms of the pathological process increase gradually as intracranial pressure increases. Common signs of cervical edema in adults include:

• sharp pain in the head that cannot be relieved even with the help of strong antispasmodics;
• constant feeling of nausea;
• vomiting (does not depend on meals and does not bring even short-term relief);
• partial/complete loss of hearing and vision, a feeling of constriction in the eyeballs;
• shortness of breath;
• arrhythmia;
• the patient is poorly oriented in time and space, looks lost, is vaguely aware of real events;
• seizures;
• speech disorder;
• neurology – sleep disturbance, sensitivity, muscle tone, fainting, lack of appetite, tremors, etc.;
• visual hallucinations;
• cerebral palsy, paresis;
• loss of consciousness – as edema progresses, the frequency and duration of attacks increases; in severe cases, a person may fall into a coma.

If a patient exhibits signs of cerebral edema and his condition worsens every day, immediate correction of metabolic disorders is required.

Diagnosis of pathology

An experienced neurologist can detect swelling of the brain at the stage of interviewing the patient or his relatives. To assess the extent of the lesion, the specialist will additionally prescribe an MRI and CT scan of the brain and bone marrow. To establish the actual cause of the formation of a pathological condition, the following is carried out:

1. blood chemistry;
2. lumbar puncture (sampling is carried out extremely rarely, as this may cause
3. additional harm to the patient’s health);
4. other neuroimaging studies at the discretion of the physician.

Treatment

Correct treatment of cerebral edema can be carried out only after identifying the source of the pathology. The main therapy is aimed at eliminating organ dehydration. Certain medical procedures are also performed to relieve the root cause and associated manifestations.

If conservative treatment methods do not produce positive results, then doctors decide on the advisability of surgical intervention (removal of the source of swelling) and trephination of the organ.

Mountain cerebral edema, or resulting from a mild head injury, often goes away on its own, but the patient should always be under 24-hour medical supervision. In such cases, it is necessary to ensure correct blood circulation in the organ to sufficiently saturate the cells with oxygen.

Emergency care for cerebral edema

If any manifestations of cerebral edema appear, you should immediately call an ambulance. Before the doctor arrives you should:

1. place the patient on his back on a flat surface;
2. give him sedatives to drink, as well as medicine to lower blood pressure;
3. cover your head in a circle with ice packs or other items from the refrigerator;
4. open all the windows in the room.

Ambulance workers must carry out urgent hospitalization in a neurological hospital, where the patient will immediately be given intravenous glucose, piracetam solution, Lasix and glucocorticoids. In addition, he will be wearing an oxygen mask to prevent oxygen starvation of the brain. Subsequently, the patient is sent to the intensive care unit or toxicology department according to indications.

Drug therapy

To effectively treat swelling of the brain, complex drug treatment is carried out:

1. Dehydration therapy. Aimed at removing excess fluid from brain tissue.
2. Infusions using loop and osmotic diuretics, hyperosmolar solutions and other drugs that have a stable diuretic effect are indicated as therapeutic procedures.
3. Oxygenation and improvement of metabolism of brain structures
4. Using these methods, it is possible to achieve restoration of metabolic processes in organ tissues, cell regeneration, stabilization of membrane structures and strengthening of the vascular wall.
5. The patient is given invasions of drugs such as Actovegin, Ceraxon, Cortexini hormones of the glucocorticoid group.
6. Elimination of the cause and relief of accompanying symptoms

Since swelling of the brain always occurs with pronounced manifestations, doctors simultaneously eliminate the existing symptoms along with the main treatment. To solve this problem, antibacterial therapy is often used, and medications are prescribed to detoxify the body.

Surgical removal of lesions is possible only after stabilization and improvement of the patient’s general condition.

Consequences

Even after complete cure of swelling of the brain and removal of the affected areas of the organ, patients rarely manage to return to normal life. There is a great danger of complications and the formation of undesirable consequences in the form of:

• systematic headaches;
• sleep disorders;
• speech, visual and mental abnormalities;
• facial asymmetry;
• strabismus;
• epileptic seizures;
• motor dysfunction.

Prognosis for recovery and survival

Toxic and “mountainous” edema of the brain are the least dangerous for humans, and usually respond well to treatment, provided that the patient was taken to the department on time.

For swelling of another origin, the success of therapy depends on the degree of neglect of the pathology. In the early stages of the disease, the painful condition is reversible. As the pathological process progresses, the chances of a full recovery rapidly decrease, and even with the effectiveness of treatment procedures, it will not be possible to restore proper functioning of the brain.

Formed comatose states often cause the death of the patient. It is almost impossible to bring a patient out of a coma with significant organ damage.

In any case, if it was possible to achieve regression of symptoms and elimination of swelling, then patients may subsequently experience residual effects after suffering swelling of the brain. These include:

• frequent headaches;
• depression;
• sleep pattern disorder;
• forgetfulness;
• inattention;
• increased intracranial pressure, etc.

In severe situations, mental disorders, motor and cognitive dysfunctions are observed, which threaten the person with disability.

Typically, cerebral edema occurs as a response of the body to various pathological conditions - head injuries, infectious diseases and various overloads. With the development of edema, brain cells and intercellular spaces quickly fill with fluid. This increases the volume of the brain, which greatly increases ICP (intracranial pressure), slows down the process of blood circulation in its tissues, and begins the active death of its cells.

In this condition, it is extremely important to quickly receive qualified medical care, since the consequences of this pathology can be very serious, even fatal.

Why does cerebral edema begin (reasons)?

Most often, cerebral edema is triggered by the presence of a traumatic brain injury (impact, consequence of a fall from a height or an accident). Serious traumatic injuries to the skull, namely its small fragments, injure the delicate tissues of the brain, causing swelling. Also, cerebral edema develops due to hemorrhage in the brain.

Another common cause of edema are some infectious diseases: meningitis, encephalitis and toxoplasmosis, subdural abscess and some others.

Another common cause of cerebral edema is ischemic stroke. With this disease, a blockage of a blood vessel occurs. As a result, blood circulation is impaired, including blood circulation in the brain. Oxygen starvation begins, brain cells begin to die, and brain edema develops.

This pathology is also caused by factors such as alcohol poisoning, carbon monoxide poisoning, or excessive intake of certain medications.

How does cerebral edema manifest itself (symptoms)?

The clinical picture of this pathology is quite pronounced. Patients complain of sudden general weakness, lethargy, and drowsiness. But the most characteristic thing is that a very severe headache occurs, which has a bursting character. The whole head hurts - in the back of the head, temples and forehead.

Patients complain of dizziness, severe nausea, and vomiting. Vision problems may appear, and problems with orientation in space may arise. There is unevenness, interruptions in breathing, speech becomes difficult, and memory is impaired. Patients often involuntarily bite their tongue due to muscle spasms. Fainting occurs.

If a person has any of these symptoms, they should be taken to a medical facility immediately. You need to understand that cerebral edema is fraught with various negative consequences and complications.

How dangerous is cerebral edema (consequences of pathology)?

The consequences of this pathology are primarily influenced by the condition that caused the swelling. For example, if the cause of cerebral edema is a stroke, the consequence is the rapid death of brain cells, and they will not recover even after treatment. Partial or even complete paralysis of the body may also occur, which makes a person disabled.

Even if the treatment of edema was successful and measures were taken on time, unfortunately, the consequences of the pathology suffered will accompany the person for a very long time. Subsequently, frequent headaches begin, insomnia worries, absent-mindedness and memory impairment appear. Communication abilities deteriorate when communicating with others.

If the cerebral edema was insignificant, the cause that caused it was also not very severe, for example, a minor concussion, then the consequences are usually minimal and will soon cease to bother you.

What to do after diagnosis of cerebral edema (treatment)?

Treatment methods are directly related to the cause that caused it. First of all, measures are taken to eliminate this cause, and it is also very important to restore the supply of sufficient oxygen to the brain cells as quickly as possible.

They use medications that can quickly and effectively reduce intracranial pressure. For this purpose, diuretic drugs are used. Intravenous administration of medications is also used to eliminate the established infection (if any).

In case of a traumatic brain injury that causes cerebral edema, oxygen is introduced into the blood using an oxygen cushion - the victim inhales a gas mixture in which the oxygen content is increased. The blood is actively saturated with it, which reduces oxygen starvation and reduces swelling. There is also a very effective treatment for injuries - hypothermia, or hypothermia.

Surgery is resorted to only in emergency cases, when the patient’s life is under serious threat, when only surgery can save him. In this case, the liquid is removed through a special catheter inserted inside. This operation is called ventriculostomy. Its implementation is associated with a great risk to the health and life of the patient. Therefore, it is usually performed by very experienced surgeons.

What drugs treat cerebral edema (folk remedy)?

When treating cerebral edema with medication, you can simultaneously drink an infusion of cornflower flowers. They contain chicorine and centaurine - substances that effectively reduce swelling of brain tissue and normalize intracranial pressure.

To prepare the infusion, pour 1 tbsp into a glass of boiling, clean, drinking water. l. dried flowers. Cover the container with the infusion with a warm, thick cloth. When cool, strain. Drink a quarter glass after meals. Be healthy!

Content

Cerebral edema is a serious pathological process, which is a severe complication of injuries, a consequence of serious diseases. The brain is located in a tight space, limited by the dense bones of the skull, so any enlargement or compression of it poses a serious danger to human life.

What is cerebral edema

A dangerous, critical condition is characterized by rapid progression: a large amount of fluid fills the perivascular intercellular space and cells, the volume of brain tissue increases, intracranial pressure increases, the vessels are compressed, impairing blood circulation in the brain. Brain edema is the body’s reaction to injury, infection, and excessive stress. Medical care must be urgent, qualified, and as effective as possible. Otherwise, the patient's death quickly occurs.

Based on pathogenetic characteristics, swelling of the brain is classified into the following types:

1. Vasogenic. Appears within 24 hours after a traumatic brain injury in the area of ​​inflammation, hematomas, ischemic areas, tumors, abscesses, and invasive interventions. This perifocal swelling leads to compression of the brain.
2. Cytotoxic. Develops as a consequence of ischemia, hypoxia (oxygen starvation), intoxication, disruption of astroglial cellular metabolism, encephalopathy, viruses, stroke, cyanide poisoning, combustion products and hemoglobin breakdown.
3. Interstitial. It appears due to the penetration of water through the walls of the ventricles into the brain tissue and accumulates around them.
4. Osmotic. Occurs as a result of metabolic encephalopathies, improper hemodialysis, polydipsia, drowning in a freshwater environment, hypervolemia.
5. Hydrostatic. Periventricular edema is a consequence of disorders with increased ventricular pressure. More often occurs in newborns.

Classification by development factors:

• postoperative – complications after surgery;
• toxic – poisoning with toxic substances;
• post-traumatic – characterized by edema and swelling of the brain as a result of injury;
• inflammatory – a consequence of inflammatory processes;
• tumor - widespread swelling with fatal outcome;
• ischemic – a consequence of stroke, hemorrhage;
• epileptic;
• neuroendocrine;
• hypertensive.

Classification by size of swelling:

• diffuse – location in one of the hemispheres;
• local – location in the focus of fluid accumulation;
• generalized – damage to both hemispheres.

Causes

Increased blood circulation occurs in the brain, so microcirculation disorders with further development of swelling develop easily. Causes:

• Hemorrhage.
• Circulatory disorders (ischemic and hemorrhagic stroke).
• Malignant tumor of intracranial localization (meningioma, glioblastoma, astrocytoma).
• Fractures of the cranial bone accompanied by damage to brain tissue.
• Metastases from cancerous tumors of any organ.
• Meningitis, meningoencephalitis.
• Intracranial hematoma after trauma.
• Fracture of the base of the skull.
• Contusion, diffuse axonal damage.
• Poisoning and severe intoxication with alcohol, neuroparalytic poisons, chemicals and toxic substances.
• Surgical interventions.
• Anaphylactic reactions due to allergies.

The causes of this disease are multiple and not only intracranial pathological changes. Complications in the form of swelling may be a consequence of any transformations occurring in the microvasculature of tissues and organs under the influence of external and internal pathogenic factors. Pathology in most cases has fatal consequences.

It is impossible to reliably determine what causes the pathology in a particular case, for what reason there was a transition from localized edema to extensive swelling. The development of the disease is influenced by many factors: gender, age, medical history, size, location, condition. Sometimes even a small injury can lead to fulminant edema, and it happens that extensive destruction of areas of the brain is limited to transient or transient edema.

In newborns

The structural features of the brain and cranial cavity in a newborn child are radically different from those in adults, since in children the body is still developing, and the nervous system of adults undergoes age-related changes. Cerebral edema in newborns is characterized by rapid development, since children have imperfect regulation of vascular tone, cerebrospinal fluid dynamics and unstable intracranial pressure.

However, nature thought out everything perfectly, and the design of the skull of newborns includes a fontanelle (soft bridges made of cartilage tissue). This anatomical feature saves the child from swelling and tissue compression at the slightest cry. The causes of swelling can be:

• hypoxia of the child inside the womb of a pregnant woman;
• birth trauma or difficult childbirth;
• congenital defects of the nervous system;
• intrauterine infections;
• infection during childbirth with meningitis and meningoencephalitis;
• congenital abscesses and cancer.

The periventricular type of swelling can be completely cured, but sometimes the consequences can be:

• developmental delay;
• epilepsy;
• hyperactivity;
• paralysis;
• dropsy or hydrocephalus;
• VSD (dystonia).

Symptoms

Clinically, signs of swelling can be divided into cerebral and focal. Symptoms of cerebral edema, their alternation and combination with each other depend on the root cause of the disease. In this regard, gradual and lightning-fast forms of swelling are distinguished. In the first case, there is time to prevent the progression of edema, and in the second, all that remains is the fight for life and slowing down the progression of the pathology for some time.

In adults

For this disease, the following groups of symptoms are distinguished:

• focal symptoms;
• clinic against the background of intracranial hypertension;
• stem symptoms.

Symptoms in adults:

1. Blurred consciousness. It manifests itself in all types of the disease and varies in severity: from stupor to deep coma. With further increase in edema, the depth of the fainting state increases.
2. Balance is disturbed when walking.
3. Headache. It happens due to chronic and increasing acute brain diseases.
4. Decreased vision.
5. Drop in blood pressure, drowsiness, weakness.
6. Nausea accompanied by vomiting.
7. Convulsions, up to loss of consciousness (the patient bites his tongue).
8. Breathing disorders.

In children

Young mothers are advised to monitor their children very closely in order to promptly notice any deviations in the baby’s behavior. The presence of a pathological condition in a child is indicated by increased intracranial pressure, neurological changes, and dislocation syndrome of brain structures. The main symptoms of cerebral edema in children are complemented by lethargy, weakness, and headache. Paresis and paralysis may appear or intensify, and the optic nerve swells.

As the pathology progresses, convulsions occur, the functions of the cardiovascular system are disrupted, and symptoms increase. The clinical picture is as follows:

• intractable hyperthermia;
• headache;
• excited state;
• "brain" scream;
• bulging fontanel;
• stiff neck;
• coma;
• sopor;
• acute renal failure;
• symptoms of occipital and temporoparietal herniation of the brain: strabismus, anisocoria, disturbance of vital functions (dislocation syndrome of brain structures);
• oculomotor crisis with gaze fixation and dilated pupils, tachycardia, increased muscle tone, hyperthermia, pressure instability (midbrain compression syndrome);
• mydriasis, vomiting, anisocoria, loss of consciousness (trunk compression syndrome);
• bradypnea, bradycardia, dysphagia, vomiting, paresthesia (impaired sensitivity) in the shoulder girdle, stiff neck, respiratory arrest (cerebellar entrapment syndrome).

Treatment

The choice of diagnostic methods and further treatment depends on the symptoms of the disease and the preliminary diagnosis. Used:

• examination of the cervical region;
• computed tomography of the head;
• Magnetic resonance imaging;
• neurological examination;
• blood test to determine the causes and levels of protein in the blood plasma, electrolytes (chlorine, magnesium, sodium, potassium);

If a small swelling can disappear spontaneously in two to four days, then in more complex cases immediate medical intervention is required. Treatment of cerebral edema includes the following methods:

1. Oxygen therapy - artificial ventilation.
2. Local hypothermia (the head is covered with ice), lowering body temperature (a now outdated method).
3. Treatment with drugs that stimulate metabolic processes, glucocorticoids.
4. Administration of medications intravenously.
5. Dehydration – taking diuretics in large doses to remove excess fluid.
6. Ventriculostomy - artificial outflow of cerebrospinal fluid from the cerebral ventricles is carried out by inserting a catheter. As a result, intracranial pressure decreases.
7. An operation to remove the cause of swelling, restore a damaged vessel, eliminate a tumor, extract a bone fragment of the skull to reduce intracranial pressure.

Consequences

What prognosis do doctors make for cerebral edema? The consequence of the pathology is decompensated changes of a general nature that occur in the body, damage to brain tissue that is incompatible with life. This pathology is very unpredictable; it is impossible to make a precise prognosis. The consequences for the patient may be:

1. The swelling progresses, transforms into swelling of the brain and results in death.
2. Complete elimination of pathology without negative consequences for the brain.
3. Removal of edema and subsequent disability of the patient.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.