home Consultations What is the danger of cerebral edema and what is the prognosis for life? Cerebral edema: symptoms and treatment Chronic cerebral edema

What is the danger of cerebral edema and what is the prognosis for life? Cerebral edema: symptoms and treatment Chronic cerebral edema

Rapidly developing accumulation of fluid in cerebral tissues, without adequate medical care, leading to death. The basis of the clinical picture is a gradually or rapidly increasing deterioration of the patient’s condition and deepening disorders of consciousness, accompanied by meningeal signs and muscle atony. The diagnosis is confirmed by MRI or CT scan of the brain. Additional examination is carried out to find the cause of the swelling. Therapy begins with dehydration and maintaining the metabolism of cerebral tissues, combined with treatment of the causative disease and the prescription of symptomatic medications. According to indications, urgent (decompressive trepanation, ventriculostomy) or delayed (removal of a space-occupying lesion, bypass) surgical treatment is possible.

General information

Brain swelling was described back in 1865 by N.I. Pirogov. Today it has become clear that cerebral edema is not an independent nosological entity, but is a secondary developing pathological process that occurs as a complication of a number of diseases. It should be noted that swelling of any other tissues of the body is a fairly common phenomenon that is not at all related to urgent conditions. In the case of the brain, edema is a life-threatening condition, since, being in the confined space of the skull, cerebral tissues are not able to increase in volume and are compressed. Due to the polyetiology of cerebral edema, in their practice both specialists in the field of neurology and neurosurgery, as well as traumatologists, neonatologists, oncologists, and toxicologists encounter it.

Causes of cerebral edema

Most often, cerebral edema develops due to injury or organic damage to its tissues. These conditions include: severe TBI (brain contusion, basal skull fracture, intracerebral hematoma, subdural hematoma, diffuse axonal injury, brain surgery), major ischemic stroke, hemorrhagic stroke, subarachnoid and ventricular hemorrhage, primary brain tumors (medulloblastoma, hemangioblastoma, astrocytoma, glioma, etc.) and its metastatic lesions. Swelling of cerebral tissue is possible as a complication of infectious diseases (encephalitis, meningitis) and purulent processes in the brain (subdural empyema).

Along with intracranial factors, cerebral edema can be caused by anasarca resulting from heart failure, allergic reactions (Quincke's edema, anaphylactic shock), acute infections (toxoplasmosis, scarlet fever, swine flu, measles, mumps), endogenous intoxications (in severe diabetes mellitus, acute renal failure, liver failure), poisoning with various poisons and some medications.

In some cases, cerebral edema is observed in alcoholism, which is associated with sharply increased vascular permeability. In newborns, cerebral edema is caused by severe toxicosis of the pregnant woman, intracranial birth trauma, entanglement of the umbilical cord, and prolonged labor. Among fans of alpine sports there is the so-called. “mountain” cerebral edema, which is the result of too sharp an increase in altitude without the necessary acclimatization.

Pathogenesis

The main link in the development of cerebral edema is microcirculatory disorders. Initially, they usually appear in the area of the lesion in the brain tissue (area of ischemia, inflammation, trauma, hemorrhage, tumor). Local perifocal cerebral edema develops. In cases of severe brain damage, timely treatment is not carried out or the latter lacks the desired effect, a disorder of vascular regulation occurs, leading to a total expansion of cerebral vessels and an increase in intravascular hydrostatic pressure. As a result, the liquid part of the blood sweats through the walls of blood vessels and permeates the cerebral tissue. Generalized cerebral edema and swelling develop.

In the process described above, the key components are vascular, circulatory and tissue. The vascular component is the increased permeability of the walls of the cerebral vessels, the circulatory component is arterial hypertension and vasodilation, which lead to a multiple increase in pressure in the cerebral capillaries. The tissue factor is the tendency of brain tissue to accumulate fluid when there is insufficient blood supply.

In the limited space of the cranium, 80-85% of the volume is cerebral tissue, from 5 to 15% is cerebrospinal fluid (CSF), and about 6% is blood. In an adult, normal intracranial pressure in a horizontal position varies between 3-15 mm Hg. Art. When you sneeze or cough, it briefly rises to 50 mmHg. Art., which does not cause disturbances in the functioning of the central nervous system. Cerebral edema is accompanied by a rapidly increasing increase in intracranial pressure due to an increase in the volume of cerebral tissue. Compression of blood vessels occurs, which aggravates microcirculatory disorders and ischemia of brain cells. Due to metabolic disorders, primarily hypoxia, massive death of neurons occurs.

Forecast

In the initial stage, cerebral edema is a reversible process; as it progresses, it leads to irreversible changes in brain structures - the death of neurons and destruction of myelin fibers. The rapid development of these disorders determines that it is possible to completely eliminate edema with 100% restoration of brain functions only if it is toxic in young and healthy patients who are delivered to a specialized department on time. Independent regression of symptoms is observed only with mountain cerebral edema, if timely transportation of the patient from the altitude at which it developed was successful.

However, in the vast majority of cases, surviving patients experience residual effects of the previous cerebral edema. They can vary significantly from symptoms that are hardly noticeable to others (headache, increased intracranial pressure, absent-mindedness, forgetfulness, sleep disturbances, depression) to severe disabling disorders of cognitive and motor functions, and the mental sphere.

To describe it in simple terms, cerebral edema is a disease in which the normal outflow of cerebrospinal fluid is disrupted. As a result of pathological changes, pressure on tissue increases, blood circulation becomes difficult and necrotic phenomena are observed. In the absence of adequate therapy, edema is fatal.

What is cerebral edema

In a normal state, cerebrospinal fluid constantly circulates in the intershell spaces of the brain, supplying tissues with nutrients and providing additional protection from mechanical damage. As a result of unfavorable factors, the volume of cerebrospinal fluid begins to increase, which leads to pathological changes and disorders.

Symptoms of edema appear almost immediately. The disease progresses rapidly. The patient's condition is gradually deteriorating. If the disease develops unfavorably, death occurs.

Types of cerebral edema

The International Classification of Diseases describes in detail the signs and pathogenesis of edema, which greatly facilitates the diagnosis of disorders and makes it possible to identify abnormalities in the early stages of development.

Depending on its nature, it is customary to distinguish several types of swelling:

Vasogenic edema - pathological disorders are preceded by increased capillary permeability. The result is an increase in the volume of white matter. Perifocal cerebral edema of the vasogenic type occurs as a consequence of internal hemorrhages, the development of tumor formations and lesions of the central nervous system.
Cytotoxic edema is the result of destruction of the structure of brain cells due to toxic poisoning. Pathological changes are reversible only in the first 6-8 hours. Critical changes occur in tissue metabolism. The causes of cerebral edema are poisoning, radiation and the development of coronary artery disease.
Hydrostatic edema - appears in disorders characterized by increased ventricular pressure. This type of swelling is observed mainly in newborns. Periventricular cerebral edema is less common in adults, mainly due to trauma and surgery.
Osmotic edema - occurs when the ratio of plasma and brain tissue deviates from the norm. Pathology appears as a complication of water intoxication of the central nervous system, metabolic encephalopathy, hyperglycemia and liver failure.

Cerebral edema in newborns can be classified as a separate category. Pathological changes are traumatic in nature or occur due to disturbances during fetal development, hypoxia, difficult childbirth, etc.

After diagnosing the disease and the factors causing swelling, a code according to ICD 10 is assigned and the appropriate course of therapy is prescribed.

What causes cerebral edema?

Brain swelling can be due to various causes of traumatic and infectious nature. It is customary to distinguish between eight main factors that cause rapidly progressive swelling of brain tissue:

The clinical manifestations and prognosis of treatment are influenced by the etiology and pathogenesis of the disease. The degree of swelling and existing complications influence the choice of therapy and medications.

How does cerebral edema manifest?

Timely detection of signs of cerebral edema in adults and newborns makes it possible to provide effective and quick assistance, which often contributes to the patient’s full recovery.

Symptoms of pathological disorders are:

Signs of developing edema also include fainting, difficulty speaking, breathing and other manifestations. The intensity of symptoms gradually increases. Brain edema causes the death of nerve tissue, so the patient experiences symptoms characteristic of problems with the conduction function of the central nervous system.

Why is cerebral edema dangerous?

Unfortunately, even timely detected disease does not guarantee complete healing of the patient. The main task of medical personnel is to prevent further spread of swelling and combat possible complications.

The mechanism of edema development is associated with the development of necrotic phenomena. It is impossible to completely restore dead nerve cells and soft brain tissue. The consequences depend on the degree of damage and the damaged area.

Even after effective therapy, the patient experiences the following complications:

In severe cases, with strokes and tumor diseases, cerebral edema is terrible because it leads to partial or complete paralysis of the limbs and disability.

Oncological diseases, even after tumor removal, are fatal in 85% of cases. Recent studies have established a relationship between coma and swelling of brain tissue.

Coma and cerebral edema

Extensive swelling is accompanied by strong pressure on the soft tissue of the brain. The body's protective functions are activated, forcing the human body to maintain necessary, vital indicators and not waste nutrients.

Coma due to edema is a protective reaction. First, the patient falls into an unconscious state. If prompt assistance is not provided, coma is diagnosed. Depending on the degree of damage and the factors that caused changes in brain function, the patient is hospitalized in the appropriate department of the hospital.

Cerebral edema in a newborn

Brain edema in a newborn most often occurs as a consequence of birth trauma. But also predisposing factors for the development of disorders are the following changes observed in the mother during fetal development:

Toxicosis.
Hypoxia.
Genetic predisposition.

Periventricular edema in a child can be completely cured. In severe cases, the following complications are observed:

Dealing with complications is quite difficult, so preventive measures are taken to prevent swelling. All patients at risk during pregnancy are prescribed a course of maintenance therapy and constant monitoring by a doctor. The consequences of cerebral edema in newborns depend on how quickly the disorders were identified and the qualifications of the treating specialist.

How and with what to relieve cerebral edema

It is impossible to relieve swelling at home. The rapid development of disorders necessitates mandatory hospitalization of the patient and the prescription of drug therapy.

Diagnosis of cerebral edema

The choice of diagnostic test depends on the symptomatic manifestations of the disease, as well as the probable cause of the swelling.

The following research methods are traditionally used:

Diagnostic criteria for edema take into account the total volume of the lesion and the localization of the process. This allows you to anticipate possible complications. For example, swelling of the left hemisphere significantly affects the patient’s intellectual abilities, and in severe conditions, paralysis of the right side can be expected.

When examining a patient, a series of tests are performed to identify the catalyst for tissue swelling. Thus, a neurological examination for alcoholism, along with the results of clinical tests, helps to accurately determine the presence of disorders even in the initial stages.

Emergency care for swelling

Brain edema can be cured! But this will require providing timely assistance to the patient and starting treatment for the disease as early as possible. Measures have been developed to help stop tissue swelling until the patient is hospitalized:

The patient must be taken to the hospital immediately. The victim is transported in a horizontal position. To make breathing easier, place a cushion under his feet and turn his head to the side. It is prohibited to place a pillow under your head.

Medicines for swelling

Immediately after the patient’s admission to the hospital, an intensive course of therapy begins, including:

In severe cases, bilateral decompression trepanation is indicated. But, since the consequences after surgery are quite high, especially due to the need to dissect the hard membrane, surgical intervention is extremely rarely resorted to.

If the catalyst that provoked the swelling is a tumor, its removal is indicated.

Treatment of cerebral edema with folk remedies

Traditional therapy methods are used after the main drug treatment. Traditional medicine is against the use of any methods that are not related to official therapy.

Due to the danger of the disease and the high probability of causing unwanted complications or provoking repeated inflammation and swelling of tissues, you can take any herbal decoctions and tinctures only after consultation with your doctor and only during the period of non-exacerbation.

Brain recovery after edema

Modern treatment of cerebral edema is aimed at preventing the recurrence of pathological changes and the maximum possible restoration of the functional activity of nerve cells and areas of the hemispheres. The prognosis of therapy primarily depends on qualified medical care.

The severity of complications depends on the speed with which treatment was started. The human brain has an amazing feature. The functions of dead cells and areas of brain tissue are taken over by nearby tissues. But this takes time. The patient, after suffering a stroke, will need to relearn how to walk and talk. Over time, there is a partial restoration of lost functions.

Cerebral edema is a dangerous condition that threatens the health and life of the patient. Tissue swelling must be treated exclusively in a hospital. Any methods of self-medication are unacceptable.

This dangerous, rapidly developing disease can lead to an irreparable, unexpected and dangerous outcome. Swelling of the brain can occur in any person and for many reasons.

For example, with a severe form of toxicosis during pregnancy, hypoxia may develop in the mother and fetus, which can subsequently cause swelling of the child’s brain.

A number of certain factors can cause brain pathology in newborns, namely:

You can suspect a pathology in your baby based on the following symptoms:

In children, cerebral edema develops very quickly. The signs progress and increase, and the baby’s condition worsens. Often the resulting brain injuries cannot be reversed, and the child may die. Therefore, treatment should begin as quickly as possible.

When treating newborns, doctors try not to resort to surgical intervention, because such a procedure can, with a high probability, end in the death of a small patient.

In the treatment of edema in children, drugs are used that remove fluid from the body, inhibit the development of edema, eliminate convulsions and normalize blood supply. In some cases, they resort to artificial reduction of the body.

The consequences of cerebral edema in children are very diverse. Often parents of such children notice developmental delays, impaired motor skills, speech, intellectual and physical abilities. In some cases, children develop epilepsy.

After a long and successful treatment, the child will be registered with a pediatrician and neurologist for a long time. In case of developmental delay or speech delay, the baby is additionally prescribed regular visits to a psychiatrist.

Planning a pregnancy should start with a consultation with a gynecologist. He will determine the presence of possible infections or viruses and prescribe proper treatment. The absence of health problems in the mother is a guarantee of the birth of a healthy baby.

Cerebral edema is a dangerous condition that requires immediate assistance to the injured patient!

Brain edema (CBE, cerebral edema) is a pathological condition associated with excessive accumulation of fluid in the brain tissue. Clinically, it manifests itself as a syndrome of increased intracranial pressure. Physicians of different specializations encounter AGM in practice:

Cerebral edema - what is it?

Cerebral edema is not an independent disease, but a clinical syndrome that always develops secondary to any damage to brain tissue.

The main triggering factor in the pathogenesis of the development of AMS is microcirculation disorders. Initially, they are localized in the area of cerebral tissue damage and cause the development of perifocal (limited) edema. In case of severe brain damage and untimely initiation of treatment, microcirculatory disorders become total. This is accompanied by an increase in hydrostatic intravascular pressure and dilation of the blood vessels of the brain, which, in turn, causes blood plasma to leak into the brain tissue. As a result, the development of generalized OGM occurs.

Swelling of cerebral tissues causes an increase in their volume, and since they are located in a confined space of the cranium, it also increases intracranial pressure. Blood vessels are compressed by cerebral tissue, which further enhances microcirculatory disorders and causes oxygen starvation of nerve cells and their mass death.

Causes of cerebral edema

The most common causes of OGM are:

severe traumatic brain injury (basal skull fracture, brain contusion, subdural or intracerebral hematoma;
ischemic or hemorrhagic stroke;
hemorrhage into the ventricles or subarachnoid space;
brain tumors (primary and metastatic);
some infectious and inflammatory diseases (meningitis, encephalitis);
subdural empyema.

Much less frequently, the occurrence of OGM is caused by:

severe systemic allergic reactions (anaphylactic shock, angioedema);
anasarca caused by renal or heart failure;
acute infectious diseases (mumps, measles, influenza, scarlet fever, toxoplasmosis);
endogenous intoxications (liver or kidney failure, severe diabetes mellitus);
acute poisoning with medications or poisons.

In older people who abuse alcohol, there is an increase in the permeability of the vascular walls, which can lead to the development of cerebral edema.

The causes of OGM in newborns are the following factors:

severe gestosis;
umbilical cord entanglement;
intracranial birth injury;
protracted labor.

In rare cases, OGM is observed in completely healthy people. For example, if a person climbs high into the mountains without the necessary stops to acclimatize the body, he may develop cerebral edema, which doctors call mountain edema.

Classification

Depending on the causes and pathological mechanism of development, several types of OGM are distinguished:

	Cause and mechanism of development
Vasogenic	Most common. It occurs as a result of damage to the blood-brain barrier and the release of plasma into the extracellular space of the white matter. Develops around areas of inflammation, tumors, abscesses, trauma, ischemia
Cytotoxic	The main causes are intoxication and ischemia, which cause intracellular hydration. Usually localized in gray matter and distributed diffusely
Osmotic	The cause of its occurrence is a decrease in blood osmolarity due to inadequate hemodialysis, metabolic disorders, drowning, polydipsia, hypervolemia
Interstitial	Occurs in patients with hydrocephalus as a result of leakage of cerebrospinal fluid into the nerve tissue around the ventricles

Symptoms of cerebral edema

The main symptom of AMS is a disturbance of consciousness of varying degrees of severity, ranging from mild stupor to deep coma.

As the swelling increases, the depth of the disturbance of consciousness also increases. At the very beginning of the development of pathology, seizures are possible. Subsequently, muscle atony develops.

During the examination, the patient is diagnosed with meningeal symptoms.

While consciousness is preserved, the patient complains of a severe headache, accompanied by painful nausea and repeated vomiting, which does not bring relief.

Other symptoms of AMS in adults and children are:

hallucinations;
dysarthria;
incoordination of movements;
visual disturbances;
motor restlessness.

With excessive OGM and wedging of the brain stem into the foramen magnum, the patient experiences:

unstable pulse;
severe arterial hypotension;
hyperthermia (increase in body temperature to 40 ° C and above);
paradoxical breathing (alternating shallow and deep breaths, with different time intervals between them).

Diagnostics

It is possible to assume that a patient has AMS based on the following signs:

increasing depression of consciousness;
progressive deterioration of general condition;
presence of meningeal symptoms.

To confirm the diagnosis, computed tomography or magnetic resonance imaging of the brain is indicated.

Diagnostic lumbar puncture is performed in exceptional cases and with great caution, as it can provoke dislocation of brain structures and compression of the trunk.

To identify the possible cause of OGM, the following is carried out:

assessment of neurological status;
analysis of CT and MRI data;
clinical and biochemical blood tests;
collection of anamnestic data (if possible).

OHM is a life-threatening condition. Therefore, primary diagnosis should be carried out as quickly as possible and begin from the first minutes of the patient’s admission to the hospital.

In severe cases, diagnostic measures are carried out simultaneously with the provision of first aid.

Treatment of cerebral edema

The founder of the Soviet school of neurosurgery N. N. Burdenko wrote: “He who masters the art of treating and preventing cerebral edema holds the key to the life and death of the patient.”

Patients with AGM are subject to emergency hospitalization in the intensive care unit. Treatment includes the following areas:

Maintaining optimal blood pressure levels. It is desirable that the systolic pressure is not lower than 160 mmHg. Art.
Timely tracheal intubation and transfer of the patient to artificial respiration. The indication for intubation is an increase in the intensity of respiratory failure. Mechanical ventilation is performed in hyperventilation mode, which increases the partial pressure of oxygen in the blood. Hyperoxygenation contributes to the narrowing of cerebral vessels and a decrease in their permeability.
Facilitation of venous outflow. The patient is placed on a bed with the head end elevated and the cervical spine maximally extended. Improving venous outflow contributes to a gradual decrease in intracranial pressure.
Dehydration therapy. Aimed at removing excess fluid from cerebral tissues. It is carried out by intravenous administration of osmotic diuretics, colloid solutions, loop diuretics. If necessary, to potentiate the diuretic effect of diuretics and supply neurons with nutrients, the doctor may prescribe intravenous administration of a hypertonic glucose solution, 25% magnesium sulfate solution.
Glucocorticoid hormones. Effective in cases of perifocal cerebral edema caused by the development of a tumor process. Ineffective in cases of acute brain injury associated with traumatic brain injury.
Infusion therapy. Aimed at detoxification, elimination of disturbances in water-electrolyte and colloid-osmotic balance.
Antihistamines. They reduce the permeability of vascular walls, prevent the occurrence of allergic reactions, and are also used to relieve them.
Drugs that improve cerebral blood circulation. They improve blood flow in the microvasculature, thereby eliminating ischemia and hypoxia of nervous tissue.
Metabolic regulating agents and nootropics. Improve metabolic processes in damaged neurons.
Symptomatic therapy. Includes the prescription of antiemetics, anticonvulsants, and painkillers.

If AGM is caused by an infectious-inflammatory process, antiviral or antibacterial drugs are included in complex therapy. Surgical treatment is carried out to remove tumors, intracranial hematomas, and areas of brain crushing. For hydrocephalus, shunt surgery is performed. Surgery is usually performed after the patient's condition has stabilized.

Complications

With a significant increase in intracranial pressure, dislocation (displacement) of brain structures and infringement of its trunk in the foramen magnum can be observed. This leads to severe damage to the respiratory, vasomotor and thermoregulatory centers, which can cause death against the background of increasing acute cardiac and respiratory failure and hyperthermia.

Consequences and prognosis

In the initial stage of development, AMS is a reversible condition, but as the pathological process progresses, the death of neurons and the destruction of myelin fibers occur, which leads to irreversible damage to brain structures.

With early initiation of treatment for AMS of toxic origin in young and initially healthy patients, complete restoration of brain functions can be expected. In all other cases, residual effects of varying severity will be noted:

persistent headaches;
absent-mindedness;
forgetfulness;
depression;
sleep disorders;
increased intracranial pressure;
disorders of motor and cognitive functions;
mental disorders.

Prevention

Primary prevention measures for cerebral edema are aimed at preventing the causes underlying its development. These may include:

prevention of industrial, road transport and domestic injuries;
timely detection and active treatment of arterial hypertension and atherosclerosis, which are the main causes of stroke;
timely treatment of infectious and inflammatory diseases (encephalitis, meningitis).

If a patient has a pathology against which the development of cerebral edema is possible, then he must undergo preventive treatment aimed at preventing swelling of the brain substance. This may include:

maintaining normal plasma oncotic pressure (intravenous administration of hypertonic solutions, albumin, fresh frozen plasma);
prescription of diuretics for high intracranial pressure;
artificial hypothermia - allows you to reduce the energy needs of brain cells and thereby prevent their mass death;
the use of drugs that improve the tone of cerebral vessels and metabolic processes in brain tissue.

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Cerebral edema is a disease that is dangerous at any age. An analysis of the causes of cerebral edema suggests that both children and adults are susceptible to this pathology.

The consequences of the disease are severe. They can lead to impaired mental functioning, disability or death of a person.

What is cerebral edema

Brain edema is its swelling, which is caused by physical and chemical processes in the body under the influence of injury or illness. The essence of edema is the accumulation of excess fluid in the brain tissue. In this case, the space is limited by the bones of the skull. As a result, compression of brain tissue occurs.

The brain centers responsible for the functioning of the brain and body may be damaged.

Types and causes of swelling

Brain edema can develop for the following reasons:

traumatic brain injury of varying severity;
poisoning with toxic substances, drugs, alcohol;
asphyxia;
the presence of tumors in the brain that compress brain tissue and blood vessels;
metastases to the brain from cancer of another location;
anaphylactic shock as a result of a severe allergic reaction;
subarachnoid hemorrhage in ischemic stroke with high blood pressure;
high intracranial pressure in hemorrhagic stroke;
hematoma in the cerebral cortex;
severe form of diabetes mellitus with increased blood glucose levels;
severe renal or liver failure;
in children: birth injuries, severe late toxicosis during maternal pregnancy, asphyxia when entangled in the umbilical cord or prolonged labor;
convulsions due to epilepsy, heat stroke, high temperature against the background of severe infectious diseases (influenza, meningitis, encephalitis, measles and others);
after surgical operations with opening of the skull;
sudden changes in pressure and lack of oxygen due to changes in altitude.

Impaired vascular permeability and increased pressure in capillaries contribute to the accumulation of water in the intercellular space, which also contributes to the formation of edema.

Cerebral edema is divided according to the degree of localization:

Local or regional edema – located in a specific area. This type of edema comes in various forms: cyst, hematoma, abscess, tumor.
Generalized (diffuse) – spreads throughout the entire brain. It develops due to a large loss of protein in the urine due to changes in biochemical processes during severe pathologies. Its development is especially dangerous when it affects the brain stem.

The risk group includes people who have problems with the cardiovascular system, abuse alcohol, and work in physical work with a high risk of injury. A separate group is newborn children.

By their nature, cerebral edema is divided into several types:

Cytotoxic edema – develops as a result of ischemia, hypoxia, intoxication; It causes an abnormal increase in the amount of gray matter.
Vasogenic – occurs against the background of the development of a tumor, abscess, ischemia, as well as after surgery. The amount of white matter increases pathologically. Active compression of the brain occurs within the cranium.
Osmotic – a pathology that appears with elevated levels of glucose and sodium in the blood; The result of the disease is dehydration of the brain, and then the entire body.
Interstitial edema - develops due to the penetration of water into the brain tissue.

OGM in newborns

Cerebral edema in children has a number of distinctive features due to the softness of the cartilaginous tissue connecting the cranial bones, the presence of “fontanelles,” and brain growth. Occurs when fluid accumulates in a child’s brain. This happens for one of the following reasons:

injuries when passing through the birth canal;
congenital pathologies of the development of the nervous system;
fetal hypoxia, chronic lack of oxygen;
congenital diseases associated with the formation of tumors in the head;
encephalitis or meningitis;
infections during maternal pregnancy, including toxoplasmosis;
prematurity, in which the amount of sodium in the blood increases.

Symptoms

Symptoms of cerebral edema appear depending on the severity of the disease.

Most often the patient is concerned about:

nausea;
vomit;
dizziness;
headache;
memory impairment;
impaired coordination of movements;
arterial hypotension (low blood pressure);
speech difficulties;
irregular breathing rhythm.

All these signs resemble complaints characteristic of a number of other diseases.

In more severe cases, convulsions and paralysis occur, leading to the inability of the muscles to contract. There may be hallucinations, facial swelling with bruising, and fainting.

Swelling of the brain can lead to coma. If the disease is not treated, death is possible.

Diagnostics: basic methods

The difficulty in diagnosing cerebral edema is that the disease hardly manifests itself in the early stages. However, it is possible to make a diagnosis by taking into account risk factors such as injury or the underlying disease that the patient suffers from. Both of these can cause swelling.

If there is a suspicion of cerebral edema, the patient must be examined in a hospital setting, usually in the intensive care unit or neurosurgery department.

Fundus examination helps to identify the disease. To clarify the diagnosis, determine the location and severity of edema, CT (computed tomography) and MRI (magnetic resonance imaging) of the brain are used. These are very informative modern non-invasive methods that allow timely diagnosis of various pathologies.

Depending on the situation, it is also possible to perform angiography and lumbar puncture. Doctors will determine the appropriateness of a particular type of research.

Treatment

Brain edema is most often treated with medication. The main goals are to improve blood flow, activate the movement of cerebrospinal fluid in the brain tissues, and remove excess fluid and toxins from them.

Treatment is carried out with constant monitoring of body temperature and blood pressure. Antibiotics, diuretics, diuretics are prescribed, and, if necessary, barbiturates as anticonvulsants.

For local swelling, corticosteroid therapy (hormone therapy) helps. To normalize metabolism in brain tissue, nootropic drugs are recommended: piracetam, nootropil, cerebrolysin.

To improve cerebral circulation, the doctor prescribes chimes, trental, and to strengthen the walls of blood vessels - contrical and other means. Often the patient is prescribed muscle relaxants and sedatives. In recent years, treatment with increased doses of oxygen – oxygen therapy – has also become an effective and recommended method.

Treatment of cerebral edema should be carried out in the hospital, and in cases where the patient may require emergency life support, in the intensive care unit.

However, drug treatment does not always give the desired effect. Then all that remains is to resort to surgical intervention. This can be either a relatively minor operation or a more complex one - craniotomy. The skull is opened if hematomas have formed in the brain tissue or the patient is diagnosed with cancer. In this case, the hematoma or tumor that caused the swelling is removed.

Consequences of cerebral edema in adults

The consequences of the disease largely depend on its severity, as well as the timeliness of diagnosis and treatment. If the underlying disease is treated exclusively, the complication of which is cerebral edema, it is difficult to give a good prognosis, and the consequences can be severe. It is possible to completely restore the functions of the affected area only with minor perifocal edema. The future looks bleaker for the remaining patients. At a minimum, they receive a disability group.

After treatment, a person often remains with such an unpleasant symptom as increased intracranial pressure. It gives the patient drowsiness, lethargy, and frequent headaches. The patient’s mental abilities decrease, and the same thing happens with his ability to communicate with people and navigate time. The quality of life of such a person noticeably deteriorates.

Another consequence of the disease is adhesions in the brain. Adhesions can form between the membranes of the brain, in the ventricles, along the flow of liquor fluid. This pathology manifests itself as headaches, depressive states, disorders of consciousness, and disorders of neuropsychic reactions.

The consequences of edema in the medulla oblongata can be very dangerous. It is in it that the most important life support centers of the body are located. The result may be disturbances in blood supply, breathing, convulsions, and epileptic attacks. If infringement or relocation (displacement) of the brain stem occurs, paralysis and respiratory arrest may occur.

The patient's death also occurs if advanced cerebral edema is not treated. In the most favorable case, this disease, suffered by the patient without treatment, will subsequently cause a decrease in intelligence and impaired brain activity. But we are not talking about the most severe form of edema.

However, there are cases of complete recovery without any consequences. This is most typical for young people who do not suffer from chronic diseases and adhere to the doctor’s recommendations. As a rule, in such cases we are talking about non-extensive local edema, most often resulting from a concussion during an accident or fight. In addition, the cause is intoxication (including alcohol), mountain sickness (can be observed in climbers). Minor swelling in these cases can go away on its own.

How do the effects of edema affect children?

It is not always possible to completely cure cerebral edema in children, as in adults. This is fraught with health problems in the future. The child may still have problems with speech and coordination of movements. Possible consequences in the form of diseases of internal organs. Children who have suffered cerebral edema may develop epilepsy, hydrocephalus, and cerebral palsy (CP).

The child may have mental retardation. Previous cerebral edema can also make itself felt by increased nervous excitability and mental instability.

Parents close to a child with cerebral edema need a lot of patience and love for their baby in order to overcome (as far as possible) the consequences of the disease.

Prevention of cerebral edema

To avoid this disease, you need to take care of the absence of domestic injuries, accidents, accidents, falls, etc. incidents. Compliance with the rules of behavior and safety at home, on the roads, when riding a bicycle, and when working on a construction site should be the norm of life.

Particular attention should be paid to your body when hiking in the mountains. You need to give your brain time to acclimatize and get used to the increased altitude.

Giving up bad habits also greatly contributes to the normalization of metabolic processes in the brain, reduction of risk factors, and greater human safety. It is necessary to get vaccinated on time, protect yourself and other people from infectious diseases and their spread, and observe hygiene and sanitation standards.

A gentle regimen, careful attitude, and a healthy lifestyle are especially important for pregnant women. Some cases of cerebral edema in infants can be prevented by constant monitoring of the mother's health, observation by a doctor throughout pregnancy, ultrasound examinations, and other measures to ensure the safety of childbirth.