Cellular edema

Edema of the brain develops with various cerebralpathological processes and is a factor that largely determines the lethality. It plays an important role in brain injury, stroke, tumors and brain abscesses, encephalitis and. meningitis, with hypoxia; hyperosmolarity, osmotic balance disorders due to dialysis or ketoacidosis, as well as occlusive hydrocephalus. "Brain edema" and "brain swelling" are synonymous and determine the increase in brain volume due to an increase in the content of water and sodium in it. Local or generalized, but moderate degree of edema may occur asymptomatically, with minor manifestations, a pronounced local edema can give focal features, a severe generalization of cerebral edema may lead to a tentorial or occipital wedge.
There are three types of brain edema: vasogenic, cellular or cytotoxic, interstitial or hydrocephalic. The vasogenic variant is associated with an increase in the permeability of capillaries. It is more common in clinical practice: with tumors and abscesses of the brain, hemorrhages and heart attacks, brain contusion and meningitis. In these cases, edema is often localized around the primary focus, causing focal symptoms, which are often more likely to be caused. edema than primary damage. Cellular, or cytotoxic, edema is characterized by the swelling of all brain cell elements (neurons, glia, endothelial cells) with a corresponding decrease in the content of the extracellular fluid. Observed with diffuse brain hypoxia and acute hypoosmolarity, which can be caused. depletion of sodium stores, or inadequate secretion of the antidiuretic hormone of the pituitary gland, or a violation of osmotic balance (in hemodialysis or ketoacidosis). Clinical manifestations usually do not have a local character and are manifested by drowsiness, which passes into a sopor or to anyone, or a convulsive syndrome. With ischemic conditions, a combination of vasogenic and cellular edema is often observed. Interstitial or hydrocephalic, edema - increased water content in the brain (mainly extracellular) - is observed with hydrocephalus.

Recognition of the type of edema affects the choice of methodtherapy. With vasogenic edema, large doses of glucocorticoids (dexamethasone) are prescribed. When the cell form is used, osmotherapy (hypertonic mannitol solution) or diuretics (furosemide, ureitis, diacarb).
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