How does the cerebral edema manifest, the causes of the onset, and what are the methods of treatment?

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1 Etiology of the disease

Brain edema can occur in both adults and children. The fact is that the reasons for the development of such a state are extremely diverse. In the event that cerebral edema develops, the causes can be rooted in the following diseases and disorders:

  • craniocerebral trauma;
  • anaphylactic shock;
  • stroke;
  • hemorrhage in the brain of any etiology;
  • infectious diseases;
  • pathology of the cardiovascular system;
  • is a burn disease;
  • oxygen starvation;
  • birth injury;
  • severe intoxication;
  • tumors;
  • differences in atmospheric pressure.

The reasons for the development of a condition such as cerebral edema in different age groups can vary significantly. To the common infectious reasons for the development of cerebral edema in different age groups is:

  • meningitis;
  • encephalitis;
  • toxoplasmosis:
  • subdural abscess.

Usually, the reason for the appearance of such a condition in newborn children is in birth trauma and congenital disorders of the tissue structure. With existing congenital disorders of the outflow of liquor, there is often a development of such a serious pathological condition as hydrocephalus. In elderly people, usually cerebral edema is observed against a background of thrombosis, hemorrhagic or ischemic strokes, as well as cardiovascular system disorders. The thing is that against the background of all these pathological conditions, the death of individual parts of the brain occurs as a result of hemorrhage or tissue ischemia caused by insufficient blood supply.

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In young people, the reasons for the development of cerebral edema are often found in various injuries received in the workplace, in the home and in car accidents. In addition, the widespread causes of edema in this category include alcohol and drug intoxication. The appearance of a tumor often causes an edema due to the fact that an increasing malignant formation is transmitting healthy tissues. The edema of the brain with changes in atmospheric pressure is often of very little character and is observed most often in people who are immersed in great depths, and in addition, in climbers.

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2 The most common types of

disease Brain edema can occur in different scenarios, each of which has its own characteristics, causes and consequences. Currently, there are 4 main types of cerebral edema, including:

  • vasogenic;
  • is cytotoxic;
  • gyrostatic;
  • is osmotic.

Vaginal edema usually develops as a result of a pathological increase in the permeability of the walls of the blood vessels in the brain. In the overwhelming majority of cases, this type of cerebral edema is observed with hemorrhages of various etiologies and tumor growths.

Cytotoxic edema, as a rule, is a consequence of brain tissue poisoning. Such a variant of edema with proper first aid may not have any irreparable consequences, but the necessary medical care should be provided no later than in 6-8 hours. In the absence of targeted treatment after the specified time, a critical change in the metabolism of brain tissues is observed, which leads to their death. Provoke this kind of edema can poisoning with natural and chemical poisons, alcohol intoxication, the use of potent narcotic drugs, as well as coronary disease and irradiation.

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Hydrostatic edema occurs when a person has a critical increase in ventricular pressure. Typically, this type of brain edema is observed in newborns. In adults, this type of edema is rare and in most cases is the result of surgery or head injury.

Osmotic type of cerebral edema can be observed in both adults and children. Usually such variant of a course of illness takes place at infringement of norm or rate of a parity of a plasma and fabrics of the brain. A similar variant of edema is in the vast majority of cases the result of infectious diseases, renal failure and improper hemodialysis, and in addition, hyperglycemia.

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In a separate group, edema is released in newborns, which can develop as a result of intrauterine developmental disorders of brain structures, birth trauma and fetal hypoxia. In newborn children, unlike adults, the development of edema can lead to minor injuries, which later do not manifest themselves in any way, and cause serious developmental disorders.

3 Symptomatic manifestations of

The clinical picture of cerebral edema is extremely diverse and largely depends on which areas of the brain are affected first. When the cerebral edema develops, death does not come immediately. Given that the accumulation of fluid in the brain tissues gradually leads to an increase in intracranial pressure, first appear characteristic signs of cerebral edema. The manifestations of increased intracranial pressure include:

  • headache;
  • attacks of psychomotor agitation;
  • drowsiness;
  • apathy;
  • nausea, aggravated by movement;
  • vomiting;
  • convulsions;
  • movement disorders of eyeballs;
  • increased head circumference in newborns.

As this state grows, diffuse neurologic symptoms appear. This is due to the fact that the cortex and subcortical structures of the brain begin to damage. The most characteristic manifestations of this disorder are repeated seizures involving the majority of the muscles of the body. There are seizures, which are very reminiscent of epileptic seizures. In addition, some patients develop pathological grasping and protective reflexes. When the swelling of the brain develops, the symptoms can grow very rapidly and provoke the patient's death.

If no targeted treatment has been conducted or if the therapy is ineffective, there is a development of coma of varying severity. In addition, there may be an increase in body temperature, with up to more than 40 ° C.An increase in body temperature in a condition such as cerebral edema can not be stopped by any antipyretic agents. Given that at this stage of cerebral edema the person is already in an unconscious state, when examining the eye reaction to light, its complete absence is determined, the difference in the size of the pupils, and sometimes the squint or "floating" eyeballs. Among other things, there is a decrease in heart rate and a lack of tendon and pain reflexes.

In the vast majority of cases, when the edema of the brain develops, it is necessary to connect the patient to the ventilator and monitor the cardiac activity. Due to the increase in damage to the brain structures, respiratory arrest may occur, therefore, full-value maintenance therapy is very important. The consequences of a condition such as cerebral edema can be very diverse. In adults, after therapy, the quality of life can deteriorate substantially, communicative abilities decrease, paralysis and paresis develop. In addition, after experiencing brain edema, patients often develop depressive states, slowing down, reducing cognitive abilities, migraines, etc.

4 Diagnosis methods

When the swelling and swelling of the brain develops, the consequences without timely diagnosis and treatment can be the saddest and even lead to death. Clinical manifestations of such a condition as cerebral edema are often sufficiently lubricated and do not allow the neurologist doctor to determine the nature of the existing lesions solely by external manifestations. To confirm the diagnosis and determine the nature of edema, the following studies are required:

  • comprehensive neurological examination;
  • MRI;
  • CT;
  • blood test.

After the appearance of suspicions on the development of a condition such as cerebral edema, the patient is urgently transferred to the intensive care unit, as often urgent therapy is required to maintain the functioning of all vital organs. Given that in some cases, patients do not immediately receive qualified care and directed treatment, often in the shortest time the development of this condition leads to the death of the patient.

5 How is the treatment performed?

In mild cases of edema of the brain, treatment is aimed at arresting the existing symptoms and removing excess fluid from the body. In such mild cases, as a rule, the main treatment is aimed at eliminating the pathology that causes the buildup of brain edema. With a favorable course, all symptomatic manifestations of cerebral edema can disappear on their own in 2-3 days. In severe conditions, treatment involves a combination of conservative and surgical methods of exposure. Therapy of cerebral edema with severe symptoms suggests:

  • maintenance of a certain level of oxygenation of the blood;
  • drug treatment of seizures and excited states;
  • intravenous administration of drugs that eliminate pain syndrome;
  • introduction of a person into a state of hypothermia;
  • introduction of diuretics.

Preparations for elimination of brain edema are selected individually for each patient. In addition, it is very important to correctly calculate the dosages and methods of administration of the drugs, since only in this case it is possible to quickly achieve reduction in edema and intracranial pressure. The most commonly used drugs:

  1. 40% glucose solution.
  2. 10% sodium chloride solution.
  3. Furosemide.
  4. Urea.
  5. Sulfuric acid magnesium.
  6. Mannitol.
  7. Corticosteroids.
  8. Dicinone.
  9. Counter.
  10. Gordoks.
  11. Ascorutin.
  12. Troxevasin.
  13. Dexamethasone.
  14. Prednisolone.

A number of drugs are prescribed to eliminate existing symptomatic manifestations and prevent even more damage to brain structures.

In some cases, for the fastest stabilization of the patient's condition, removal of the skull fragment can be indicated.

This operation allows you to quickly reduce intracranial pressure.

In some cases, an operative procedure is performed to eliminate the underlying cause of the development of cerebral edema, for example a tumor, if it is operable, or to repair a damaged blood vessel. After stabilization of the patient's condition, targeted therapy is required, and sometimes long-term rehabilitation. It is often required and prevention of repeated cases of cerebral edema.

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