Perifocal cerebral edema treatment
Edema of the brain ( OGM) is a pathological condition,characterized by excessive accumulation of fluid and sodium ions in the brain tissue. Sufficiently conditionally distinguish 3 types of OGM: cytotoxic, vasogenic and ischemic. In a real clinical situation, all three mechanisms with the predominance of one of them usually participate in the development of the UCL. Modern technologies (MRI [diffusion-weighted image]) allow distinguishing cytotoxic edema from vasogenic.ICD-10 International Classification of Diseases Code:
- G93.6 Edema of the brain
• Cytotoxic OCM develops due to disturbance of osmoregulationcell membranes, resulting in the swelling of the latter. BBB is not violated, in connection with which the proteins of the blood plasma do not leave the vascular bed. Cytotoxic edema is observed, for example, with CCT.
• Vasogenous OGM is caused by a violation of the BBB permeability. Proteins of blood plasma leave the vascular bed and exit into the intercellular space, causing accumulation of fluid in them and their expansion. With vasogenous OGM, HA is effective (eg, dexamethasone). A classic example is the area of perifocal edema around the metastasis of the tumor in the brain.
• With ischemic OCM pathogenetic mechanisms of the vasogenic andcytotoxic OGM are combined at different stages of its development. Initially, the BBB is not impaired, but in the future its permeability rises. The volume of the interstitial space first decreases, and then increases as a result of extravasation of the liquid. Such a staged mechanism for the development of OCM explains the delayed deterioration of the state with intracerebral hemorrhages.
The main pathophysiological state. to which ultimately leads any OCM - an increase in ICP. It is this parameter that requires correction.
Treatment. It should be borne in mind that in most casestreatment does not require the edema of the brain as such, but the disease that led to its development. Of the therapeutic measures directed not at the underlying disease, but for the elimination of OCM the most effective are dehydrating agents and GK.
Forecast is determined by the underlying disease that caused the OCM.
Abbreviations. OGM - edema of the brain.
ICD-10. G93.6 Edema of the brain
Medicines and medicines are used to treat and / or prevent "brain edema."
Medical preparations or medicines included in the pharmacological group.