Edema of the brain of the stage
How fluid can get into our brain and causeswelling of the brain? The question is interesting, but it is not so easy to answer it, because there can be many and many different reasons. The most important thing you need to know about cerebral edema is read in the article.
Edema of the brain: causes and varieties
Edema of the brain is a pathological process,characterized by excessive accumulation of fluid in the brain tissue. Developing at the same time, an increase in the volume of the brain leads in most cases to an increase in intracranial pressure. For cerebral edema, accumulation is not so much extracellular fluid as an increase in the volume of water inside the brain cells, primarily glial cells. In connection with this, the term "edema-swelling of the brain" is often used.
The edema of the brain happens - tumor, traumatic,postoperative, toxic (intoxication), inflammatory, ischemic and hypertensive. Perhaps the development of cerebral edema with epileptic seizures, diseases of the blood and internal organs, endocrine disorders, hypoxia, exposure to ionizing radiation.
In the development of cerebral edema takeinvolvement of circulatory, vascular and tissue factors. Circulatory factors imply, on the one hand, a significant increase in blood pressure in the capillaries of the brain due to increased blood pressure and the expansion of the cerebral arteries: this increases the filtration of water from microvessels into the intercellular spaces of the brain and damages its tissue elements, on the other hand, with a generalized (general) or local insufficiency of the blood supply to the brain tissue, its structural elements are damaged and become prone to accumulation of water (ischemic and postischemic edema RSA). Vascular factors are a violation of the permeability of the walls of the microvessels of the brain, as a result of which the molecules of the protein and other components of the blood plasma pass through the broken barrier into the tissue spaces of the brain, which not only increases the osmolality (the amount of osmotically active particles) of the intercellular fluid, but also damages the cell membranes, function of neural elements of the brain. Tissue factors - primary damage to cell membranes and cytoplasm of brain neurons; This breaks the transport through the membranes of ions and water, which accumulates inside the cellular elements, primarily glial, causing them to swell.
By prevalence, local and generalized (covering one or both hemispheres) edema of the brain are isolated.
Symptoms of brain edema are associated with an increase in itvolume and increase in intracranial pressure. There are paroxysmal headaches of a bursting nature, at the height of which there can be vomiting, a disorder of consciousness by the type of stunning, a change in the activity of the cardiovascular system. A common symptom is a disorder of the optic nerves.
With the growth of edema and displacement of the brain inaperture of the cerebellum and a large occipital opening, the following symptoms appear: the defeat of the oculomotor nerves (dilated pupils and the decrease of pupillary reactions), paresis or paralysis of the gaze upward, etc. When the posterior cerebral artery is compressed, visual impairment may occur. There may be vestibular disorders, sudden vomiting, stiff neck arises. It is possible to stop breathing.
Diagnosis of cerebral edema is difficult in communicationwith the absence of specific clinical and neurological symptoms. The diagnosis is based on data on the underlying disease, the manifestations and results of additional studies (eg, the fundus). It should be remembered that in the early stages of cerebral edema may occur asymptomatically.
If there is a suspected cerebral edema in the patientmust be urgently hospitalized in the neurosurgical or resuscitation department. Direct diagnosis of cerebral edema is possible with computed tomography, which allows to detect a decrease in the density of the brain substance, to assess the degree of edema expression, its prevalence. A valuable method of diagnosis is nuclear magnetic resonance imaging, in which areas of hyperhydration (excess water content) of the brain substance are determined.
Treatment of edema and swelling of the brainis based on the elimination of the cause that caused it, as well as on the removal of excess fluid, normalization of cerebral circulation and permeability of the blood-brain barrier, correction of metabolic disorders. Conditionally it is possible to distinguish specific and nonspecific treatment. Nonspecific treatment is aimed at normalizing respiration, cardiac activity, central venous pressure, kidney function, etc. on the elimination of factors contributing to the development of cerebral edema. Specific treatment is carried out with preparations of glucocorticoid hormones (dexamethasone, etc.). Dehydration therapy (fluid reduction), treatment aimed at improving microcirculation of cerebral blood flow is necessary. Apply diuretics, vitamins, ganglioblokatora, antihypoxants, sometimes carry a moderate hypothermia (cooling).
The prognosis is always serious and depends on the severity of the underlying disease, timeliness and adequacy of treatment. With progressive development of edema, the patient may die.
Based on the article "Edema of the brain."