Edema with intracranial pressure
Veroshpiron is administered orally 200 mg 2 - 3 times a day. Its effect is manifested only within 2 - 3 days after the introduction. It can be used simultaneously with osmotic diuretics.
It is necessary to control the electrolyte balance, - veroshpiron causes hyperkalemia and hyponatraemia.
Hypoxia protectors are used to reduce the damaging effect of oxygen deficiency on the cellular structures of the brain, in particular with edema.
This action has nootropil (piracetam),Cerebrolysin and aminalon (gamma-lon, the latter with intravenous administration). Piracetam stimulates redox processes in the brain, enhances the utilization of glucose, improves blood flow in the ischemic zone, and thus helps stabilize the functional activity of neurons in hypoxic conditions.
Introduced intravenously for 2-3 g 2 - 3 times a day.
Cerebrolysin An aqueous solution of amino acids. When the brain edema is inhibited and to a certain extent compensates for intracellular metabolism of amino acids, and also limits the damaging effect of anaerobic glycolysis. With increased intracranial pressure and cerebral edema, cerebrolysin is administered intravenously: 2 to 3 ml of jet or 10 to 20 ml of cerebrolysin are diluted in 250 ml of isotonic sodium chloride solution and injected for 60 to 90 minutes. Injections can be repeated at intervals of 8 to 12 hours. Complications are not described.
Cerebrolysin should not be prescribed in cases,when earlier there were convulsive seizures. Gamalon helps compensate for impaired processes of amino acid metabolism and glycolysis in the brain, enhances energy processes, increases brain oxygenation, utilization of glucose by its tissues, activates the removal of metabolic products from the intercellular space.
With edema of the brain and other urgent conditionsis effective only with intravenous administration. 20 ml of a 5% solution (1 ampoule) is diluted in 300 - 500 ml isotonic sodium chloride solution; injected slowly - no more than 20 - 30 drops per minute. A faster, and moreover a jet, introduction can cause collapse.
"Urgent condition in neuropathology", BSVilensky
Stabilization of the water-electrolyte balanceis necessary because the content of water and electrolytes undergoes significant changes during the administration of hyper-viscosity solutions. The main indicator of the balance of fluid in the body.
Encephabol (pyriditol) with edema of the brain is not administeredfollows. Encephabol causes increased production of serotonin in the edema zone and increased convulsive activity. Many authors in recent years recommend the appointment of barbiturates.
In the same section:
General characteristic of the change in intracranialPressure Low numbers of liquor pressure detected during the study can be explained by various causes: hypophyseal liquor; cerebrospinal fluid (this phenomenon is more common in neurosurgical practice); a sharp edema of the brain, preventing penetration of cerebrospinal fluid from the cranial cavity into the subarachnoid space of the spinal cord; blockade, violation of the permeability of liquor-conducting.
Symptoms of liquor hypotension are nonspecific -headache, dizziness, worsening of hearing, vomiting, tachycardia, sweating, depression of consciousness. As a symptomatic measure, repeated intravenous administration of an isotonic solution of NaCl (250 ml each) is recommended. Increase in intracranial pressure is one of the most frequent and severe complications of brain damage. It can arise due to a number of reasons: an increase in volume.
In addition to the above intracerebral andextracerebral processes that limit the volume of intracranial space, as well as inflammatory lesions of the brain and its membranes, the causes of cerebral edema may be various exogenous and endogenous intoxications, allergic conditions. Depending on the cause, edema at first may be limited, and then gradually spread to large areas of the brain . Immediate.
Vasogenic edema is characterized by increasedthe permeability of brain cell membranes to blood serum macromolecules (proteins) tends to be more rapid and more widespread than cytotoxic; the reverse development in the case of revascularization of the affected area occurs more slowly. This is because a significant part of the serum proteins "settles" in the cellular structures of the brain, promoting changes in the immunological.
Recently, in neurosurgical practiceThe method of dynamic pressure recording in the epidural space is used. Comparative studies have shown that it correlates with intracranial pressure. A miniature sensor for dynamic recording and graphic recording of pressure in the epidural space is fixed in the milling hole. The advantage of this method is the ability to fix frequently occurring ones.