Cerebral edema: causes, symptoms, treatment, effects, coma

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

The essence of the disease

This pathology is nothing but the reaction of the body to damaging factors. It can be an infectious disease, traumatic injury or excessive workload.

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

As a result, blood circulation deteriorates, and brain cells die. Often this pathology occurs in toddlers.

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In children, the following factors can lead to the disease:

  • craniocerebral trauma;
  • tumors;
  • infectious diseases.

Newborn babies may suffer from this pathology due to hypoxia, mother's diseases, toxicoses during pregnancy, trauma during childbirth.

Types and classification of

Depending on the origin, there are four main types of edema:

  • Vaginal edema. This pathology implies a violation of the blood-brain barrier, which causes the penetration of plasma proteins. Often it is observed with tumors of the brain.
  • Cytotoxic edema. To its development lead disturbances of osmoregulation of cell membranes. Their permeability causes excessive swelling of the white matter. Usually this type of cerebral edema is observed with trauma to the skull.
  • Ischemic edema. Assumes the operation of these mechanisms, but they progress in stages. An example may be cerebral hemorrhage. Most often, such swelling occurs during a stroke or after it.
  • Interstitial edema. In this situation, the brain tissue is impregnated with an excessive amount of cerebrospinal fluid. This condition is characteristic of hydrocephalus.

Depending on the development of edema, you can identify such types of pathology:

  • postoperative( usually such edema occurs as a consequence of complications after surgery);
  • is post traumatic( occurs after trauma and is characterized by cerebral swelling);
  • toxic( this type of cerebral edema can develop, for example, alcoholism or poisoning with poisonous substances);
  • is a tumor( not infrequently this type of edema causes death of the patient, because it affects the vast areas of the brain);
  • is inflammatory( occurs after an inflammatory process);
  • epileptic( edema on the background of epilepsy);
  • is ischemic( usually develops after a stroke or hemorrhage);
  • is hypertensive;
  • is neuroendocrine.

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

  • Local - located in the vicinity of the lesion.
  • Diffuse - it is localized in one hemisphere.
  • Generalized - observed in two hemispheres.

The site of edema dislocation determines such types of pathology:

  • Brainstemial edema. Extremely dangerous condition, which is associated with the disruption of vital functions - respiration, circulation, etc.
  • Edema of cerebral vessels.
  • Edema of the brain substance.

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

According to 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 "Edema of the brain."

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Causes of cerebral edema

Disease, infection, traumatic damage, and sometimes even elevation drop can lead to edema development. Most often identify such causes of this pathology:

  • Traumatic brain damage. This is a mechanical damage to the structure of the skull. Often complicated because of the wounding of the brain with bone fragments. Severe edema does not allow fluid to flow out of the brain tissue.
  • Ischemic stroke. Frequent pathology associated with abnormalities of cerebral circulation. Brain cells do not get enough oxygen, and so they begin to die, which leads to the development of edema.
  • Hemorrhagic stroke. It is associated with damage to the cerebral vessels. Hemorrhage causes increased intracranial pressure.
  • Infections:

    - encephalitis;

    - subdural abscess;

    - meningitis;

    - toxoplasmosis.

  • Tumors. During the development of such education, the area of ​​the brain is squeezed, which leads to a violation of blood circulation and edema.
  • Vertical drop. There is information according to which a height of one and a half kilometers above sea level can cause cerebral edema.

Symptoms and signs

Symptoms increase with increasing intracranial pressure.

If the edema progresses, the structures of the brain may shift, wedge into the occipital opening.

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

In the early stages, you can notice the following symptoms:

  • Headaches, which are often bursting.
  • Loss of orientation in time and space.
  • Feeling of anxiety.
  • Nausea and vomiting in high-intensity headaches.
  • Stunning.
  • Drowsiness.
  • Narrowing of pupils.
  • Respiratory depression.
  • Pressure increase.
  • Arrhythmia.

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

Also, as the pathology progresses, coordination of movements is disrupted, the act of swallowing is disturbed, severe vomiting, stiff neck muscles, cyanosis, extinguish tendon reflexes.

Sometimes a person loses consciousness, there may be cramps. In the most difficult situations, a person falls into a coma.

Diagnosis

Photo CT of cerebral edema

To make the correct diagnosis, you should perform a set of procedures:

  • Analysis of anamnesis. The doctor finds out the 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.
  • Inspection of the fundus. This condition is characterized by edema of the optic nerve.
  • Lumbar puncture. In the lumbar region, a puncture is performed to determine the increase in intracranial pressure.
  • Computer and MRI( magnetic resonance imaging).Using these procedures, it is possible to assess the signs of edema.
  • Measurement of intracranial pressure. To this end, a special sensor is inserted into the cavity of the ventricles of the brain.

First Aid Emergency

If there is edema of the brain, the patient must first provide first aid.

It includes the following activities:

  • Local hypothermia. To do this, the person's head should be covered with ice packs.
  • Intravenous injection of 20-40 ml of glucose( 40%).
  • Introduction of glucocorticoids - dexamethasone( 6-8 ml), prednisolone( 30-60 mg).
  • Introduction of Lasix on physiological solution - 20-40 ml.
  • Inhalation of oxygen.
  • Administration of piracetam solution intravenously - 10-20 ml.

After first aid, a person is placed in a neurological hospital. If there was a trauma to the skull, it is placed in the neurosurgical department.

In case of toxic edema of the brain, especially in case of coma, a person is hospitalized in a toxicological or resuscitation department.

It is not possible to remove cerebral edema on your own, so you should always seek medical help.

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Treatment of cerebral edema

There are situations when all the signs of the disease disappear on their own - this concerns some forms of mountain sickness or a slight concussion.

Other cases require immediate medical attention. How to treat cerebral edema is solved only by a specialist, considering all the features of the pathology.

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

  • Oxygenotherapy. This procedure involves the introduction of oxygen into the respiratory tract. This is done by using an inhaler or other equipment. Thanks to this, the brain nutrition improves, which allows shortening the recovery period.
  • Hypothermia. It implies a decrease in body temperature. Despite the fact that this method perfectly corrects the edema of the brain, 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. Implies drainage of excess fluid through a special catheter.
  • The choice of medications is carried out depending on the cause of 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 allows to reduce intracranial pressure.

Also during the operation, the cause that caused this pathology can be eliminated. If necessary, remove the tumor formation or restore the damaged blood vessel.

Help with edema can be provided by folk remedies, however, they can be applied only after consulting a doctor:

  • Decoction of mistletoe white. It is used in the development of education in the brain. For its preparation you need to take 200 grams of milk and 3 grams of dried mistletoe flowers. The doctor should choose a dose.
  • Propolis tincture. For 1 gram of propolis you need to take 10 grams of alcohol. Fill propolis with alcohol and insist until it is completely dissolved, then strain. Eat a teaspoon before eating. You need to do this three times a day.

Consequences and prognosis of

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

Often there are such conditions as:

  • Sleep disturbance.
  • Depression.
  • Scattering.
  • Physical activity disorder.
  • Constant headaches.
  • Violation of communicative abilities.

The course and consequences of the disease is largely influenced by the adequacy and timeliness of treatment. During the swelling, there is a pressure on the structure of the brain, which can lead to violations of the heart, respiratory organs.

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

Brain edema is a dangerous disorder that, if not properly treated, causes serious health consequences. Therefore, it is very important to immediately seek help from a doctor - thanks to this you will be able to save not only health, but life as well.

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