1 The aetiological factors of
OGM disease are rapidly emerging as a result of trauma, bruising, inflammation of brain tissue, under the influence of excessive loads, some infections. Healthy brain tissue is squeezed. The development of arterial hypertension for a long time, ischemic stroke, drug addiction, alcoholism, climbing to the mountains above 1.5 km - these factors can cause cerebral edema.
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The reasons connected with the autonomic nervous system are of great importance. Intravascular and vascular lesions are typical for OCM.About 0.07% of cases of pathology are registered among newborns. At the age of 4-12 years there is a peak incidence in children. In any age period, there may be a cerebral edema associated with trauma.
2 Species of OGM
They differ in treatment methods, genesis, location of painful foci, rate of development of the disease.
There are 4 types of pathology:
- Exposure to bacteria, toxic substances, brain malnutrition in cerebral ischemia, impaired cellular osmoregulation, swelling of membranes of brain cells - causes of cytotoxic OCM.Pathology develops as a result of oxygen starvation immediately after tissue damage.
- With interstitial OCM, vascular permeability does not change. In the ventricles of the brain, intracranial pressure increases - ICP.Pathology occurs due to headache - hydrocephalus.
- Bacterial meningitis, epilepsy, tumors or metastases in the brain are the causes of vasogenic OCM.The permeability of the wall of the capillaries rises. Proteins of the blood plasma go out into the intercellular space from the vascular bed. Such high-molecular nitrogen-containing compounds expand as a result of the accumulation of sodium and liquid ions in them. In the intercellular substance of the brain, neuronal death occurs. This is the most frequent variant of pathology.
- Osmotic edema develops as a result of salt excretion, water intoxication of the central nervous system.
Depending on the affected area, OGM is isolated:
- diffuse( one hemisphere is affected);
3 Clinical picture of the disease
Through the walls of the vessels swims the liquid part of the blood. The brain swells, increases in volume. Violation of cerebral circulation is associated with increased intracranial pressure. The displacement of the brain structures in the occipital foramen is due to the progression of the edema. Deterioration of cerebral circulation is the cause of cell death. Part of the brain is destroyed irrevocably. The patient feels strong attacks of a headache of a bursting nature.
General somatic lethargy. Reduced mental activity, a constant desire to sleep are noted at the beginning of the disease. Problems with speech. Memory losses. Paroxysmal contraction of muscles - convulsions. Spontaneous dizziness accompanied by panic fear, deterioration of balance, severe vomiting. Loss of normal ideas about space and time. A weakened reaction to irritation, complete immobility - stupor.
Often there are stops and malfunctions of breathing. Reflexes of tendons die away. The tonus of the muscles of the occiput rises. Swallowing acts are violated. There is a visual impairment. Paralysis of the oculomotor nerve develops. There is a diplopia - double vision of the visible image. There is a dilated pupil. Their reactions are significantly reduced. Vision disappears completely if the artery of the posterior parts of the brain is squeezed.
Very quickly develops cerebral edema in children( ICD-10 code - G93.6).If OGM develops in a newborn, the patient constantly screams with a sharp, piercing voice. Later, a co-morbid condition sets in, which is characterized by loss of consciousness, loss of arbitrary reflexes. There is hyperthermia - an increase in body temperature.
If, due to the microcirculation disorder, the capillaries are not adequately provided with blood, this causes the development of necrosis, ischemia is aggravated. If you do not treat cerebral edema, you can have the most deplorable consequences, often a coma develops. Increased risk of death.
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4 Diagnostic tests
A neurologist diagnoses and prescribes treatment. The nature of the disease can be detected with the help of a general blood test. The type, magnitude and location of the edema are determined using a tomogram of the brain. Neurologic examination gives a complete picture of pathology.
5 Therapy of cerebral edema
Depending on the cause and symptoms of the disease, the doctor determines the tactics of treatment. In most cases, it is necessary to treat a disease that caused brain edema.
- It is necessary to apply ice and remove excess liquid as soon as possible. Pathological changes are reversible if the blood supply is quickly restored. The edema disappears when the necrotic masses dissolve.
- Neuroleptics, anticonvulsants are often used to relieve involuntary muscle contraction.
- Depending on the type of edema, dehydration therapy is selected.
- Correction of the increase in ICP is required. Diuretics, glucocorticoids have the ability to reduce ICP, reduce cerebral edema.
- Usually, OGM quickly disappears if adequate measures are taken. Treatment is delayed with traumatic edema of the brain or OGM of infectious genesis. Trepanation of the skull is performed on vital indications for decompression of the brain.
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When swelling of the brain immediately requires the most effective qualified medical care, because this is a very serious pathology.