Due to its swelling and swelling

Swelling and swelling of the brain - an increase in brain volume due to a violationwater-salt metabolism in the brain tissue. Edema and swelling of the brain are phases of the same process. In the initial stages of development they are reversible. When swelling fluid accumulates in the perivascular and interstitial cracks of the brain, when swollen, it binds with colloids of proteins and cell lipoids and paraplastic substances of brain tissue due to an increase in their hydrophilicity.

In the pathogenesis of edema - swelling of the brain the leading role is played by vasomotor trophicviolations. Attention is also given to the reflex mechanisms and the adaptation-trophic centers of the intermediate brain. Morphologically, with edema, there is an increase in brain volume, flattening of the gyri and smoothing of the furrows, the medullary substance on the incision is shiny and moist. Venous hyperemia with capillary stasis is noted, cerebral cisterns are overfilled with cerebrospinal fluid. When swelling the surface of the brain is dry, white matter is greatly increased in size. Microscopically marked swelling of myelin sheaths and axial cylinders, plasmodendrosis of astrocytic glia with subsequent melting of cell bodies.

Swelling - swelling of the brain is an almost constant componentcraniocerebral trauma and brain tumors, can also develop with intracranial hemorrhages, intoxications and infections. Clinically expressed in the symptoms of intracranial hypertension (see Hypertension syndrome), with limited and perifocal edema - in the appearance and growth of focal symptomatology.

Treatment - introduction into the body of various dehydratingmedicines for the purpose of combating edema-swelling of the brain and for reducing intracranial pressure. Apply hypertensive solutions: glucose (20-40 ml 40% solution intravenously), sodium chloride (10-20 ml 10-15% solution intravenously), sulphate magnesia (10 ml 25% solution intramuscularly). Assign mercury and other diuretics (novurit by 1 g intramuscularly, hypothiazide to 0.025 g or fonurit to 0.25 grams of crystalline urea per kg of body weight.) Before the introduction of urea, it is necessary to study the function of the kidneys and residual blood nitrogen.Glycerin has a good dehydrating effect, which is injected through the probe into the stomach at a dose of 0.75-1 ml per 1 kg of the patient's weight.Corticosteroid preparations with anti-edematous and anti-inflammatory properties (cortisone, prednisone, ACTH) are also used.The dehydration eff (diphenhydramine, pipolpene, pernin, suprastin) are recommended to increase the resistance of the hemato-encephalic barrier, it is recommended to limit fluid intake and distracting treatment (mustard, hot foot baths) .This is expedient for hypertensive enemas and salt laxatives, 2-3 times a day). The most dehydrating effect is urea (lyophilized urea, urogluk), which is intravenously dripped in the form of a 30% solution prepared on a 10% glucose solution from the calculation.

Handbook of Clinical Surgery, edited by V.A. Sakharov