Torasemide with edema of the brain


Clinical Characteristics cerebral edema


To acute edema of the brain lead primarily closed (concussions, bruises, compression of the brain) and open craniocerebral injuries, toxic effects - poisoning with alcohol and its surrogates, drugs, etc.


Cerebral edema characterized by a sharp upward riseintracranial pressure with drowsiness, difficulty in orientation in place and time, inadequate behavior; all can end with a coma, that is, an unconscious state with no reaction to any stimuli. Tendons, periosteal and corneal reflexes are either reduced or absent, in the terminal stage, cardiac activity is reduced and blood pressure is lowered.


Since the nature of emergency brain edema has some peculiarities, to whom, due toedema of the brain, should be differentiated with coma of another origin. At an alcoholic coma the smell of alcohol from a mouth, cyanosis of the face, hands (but there is a combination of an alcoholic coma with a trauma of a skull!) Are noted. The uremic coma develops gradually, characterized by the pallor of the skin, the smell of urine from the mouth. With hepatic coma there is jaundice, the liver is enlarged, on the skin - vascular "sprouts" and "spiders". Diabetic coma is characterized by the smell of acetone from the mouth, sharp, noisy breathing, dry skin, soft eyeballs. With hypoglycemic coma normal breathing, excessive sweating, clonic convulsions.


Measures for swelling of the brain:


• local hypothermia - the head should be covered with ice bladders or other sources of cold;
• 20-40 ml of 40% glucose are intravenously administered;
• introduction of lasix from 20 to 40 ml in physiological saline;
• administration of glucocorticoids - 30-60 mg of prednisolone, 6-8 ml of dexamethasone;
• In the complex treatment of cerebral edema, oxygen inhalation is of great importance, intravenous administration of a solution of piracetam from 10 to 20 ml.


The patient must be hospitalized inneurological, and with a trauma to the skull - to a neurosurgical hospital. Edema of the brain of toxic origin (poisoning), especially in the presence of coma, involves hospitalization in the resuscitation or toxicology department. You should call, if possible, a resuscitation team or a neurological ambulance.