Extensive cerebral edema. Causes and consequences of cerebral edema of the head

Cerebral edema is the result of interconnected physical and biochemical processes occurring in the body due to diseases or pathological conditions.

This complication, depending on its severity, can go almost unnoticed, for example, with a mild concussion. But most often the consequences of cerebral edema are severe complications:

changes in mental and mental activity;

motor dysfunction;

auditory;

visual;

coordination functions, which leads to disability of the patient;

Quite often, cerebral edema causes death.

What is cerebral edema?

The essence of the definition of this condition is the nonspecific response of the entire organism to the influence of severe damaging factors. The latter may be the reason:

changes in plasma protein (oncotic) and electrolyte (osmotic) pressure;

violations of the acid-base state (pH) of the blood;

disruption of energy, protein and water-electrolyte metabolism and accumulation of lactic acid in nerve fibers;

oxygen starvation of brain tissue, especially if it is combined with excessive accumulation of carbon dioxide in the blood;

disturbance of blood microcirculation in brain tissue.

All these reasons provoke the development of swelling and edema of the brain. Edema provokes a violation of the permeability of the capillary walls and the release of the liquid part of the blood into the surrounding tissues. When swelling occurs due to the difference in oncotic pressure, water molecules begin to flow directly into the nerve cells through the membrane. Here they interact with intracellular proteins, as a result, the cells increase in volume.

However, most authors of scientific studies consider swelling as one of the stages of edema, which leads to an increase in the volume of the brain. This situation provokes its displacement around its axis in a confined space, which is limited by the bones of the skull.

The spread of cerebral edema causes compression of the medulla oblongata and other underlying structures in the foramen magnum. This zone contains vital regulatory centers that control thermoregulation, cardiovascular activity, and respiration.

Signs of cerebral edema are manifested by impaired functioning of brain centers and nerve cells even before the onset of complete damage to the structures of the latter, which is determined only with the help of modern diagnostic methods.

Types and causes of cerebral edema

There are 2 types of cerebral edema:

regional or local edema - limited to a certain area that surrounds the pathological formation in the brain tissue; cyst, hematoma, tumor, abscess;

widespread or generalized – covers the entire brain. It develops as a result of the loss of a large volume of protein in the urine due to poisoning and various diseases, intoxication, drowning, suffocation, traumatic brain injury, and hypertensive encephalopathy, which occurs against the background of severe forms of increased blood pressure and other disorders.

In many cases, excluding asphyxia and traumatic brain injury, identifying cerebral edema is a difficult task against the background of clinical manifestations of other pathological conditions and diseases. The onset of the development of edema can be suspected when, against the background of a lack of progress or a decrease in the symptoms of the underlying disease, neurological symptoms begin to increase and progress.

The main reasons for the development of cerebral edema:

traumatic brain injury, laryngeal stenosis if the child has an acute respiratory infection, asphyxia with vomit after an alcoholic coma, brain contusion;

subarachnoid hemorrhage, which occurs due to a stroke in the presence of high blood pressure;

brain tumors;

subdural hematoma, which forms under the dura mater as a result of exposure to mechanical factors without compromising the integrity of the bones of the skull;

cerebral edema in newborns due to birth trauma to the child’s brain, severe gestosis in the mother, prolonged labor, umbilical cord entanglement;

poisoning with medications, gases, chemical poisons;

severe allergic reactions, anaphylactic shock;

severe diabetes mellitus, especially if it occurs with episodes of hypoglycemic state, hepatic-renal or liver failure of chronic or acute form;

diseases that are accompanied by convulsive syndrome - epilepsy, heat stroke, hyperthermia in children with infectious diseases;

gestosis in the second half of pregnancy - eclampsia, preeclampsia, severe nephropathy;

acute infectious diseases - encephalitis, meningitis, influenza, including severe childhood infections - chicken pox, scarlet fever, measles, mumps.

In addition, cerebral edema is almost always observed after cranial surgery. In some cases - after operations that are performed under epidural or spinal anesthesia or are accompanied by significant blood loss, due to a prolonged and pronounced decrease in blood pressure, with intravenous administration of excessive amounts of hypotonic or saline solutions during the operation, as a result of difficulties in tracheal intubation to provide artificial ventilation lungs or inadequate anesthesia, ventilation.

Symptoms of cerebral edema

Depending on the duration of the disease, the location of the lesion, the rate of increase and the extent of the process, the clinical manifestations of cerebral edema may differ. Limited (local) edema is manifested by general cerebral symptoms, much less often these are signs that are characteristic of a specific part of the brain. With the increase or presence of initially generalized edema, but slowly increasing, there is a gradual increase in the number of symptoms, which mean damage to several parts of the brain at once. All symptoms can be divided into groups.

Signs of increased intracranial pressure:

headache;

lethargy and drowsiness;

gradual increase in depression of consciousness with the appearance of nausea and vomiting;

dangerous convulsions - clonic (short-term, sweeping contractions of the muscles of the face and limbs), tonic (prolonged muscle contractions, as a result of which certain parts of the body acquire an unusual position for themselves), clonic-tonic, provoking an increase in cerebral edema;

a rapid increase in intracranial pressure provokes the development of bursting headaches, disturbance of eyeball movement, and repeated vomiting;

cerebral edema in infants (children under 1 year of age) provokes an increase in head circumference; after the fontanelles close, their opening develops due to displacement of the bones.

The appearance of scattered (diffuse) neurological symptoms

The phenomenon is reflected by the increase in the pathological process, which carries the risk of developing coma in the presence of cerebral edema. This is provoked by the involvement of the cerebral cortex in the initial process, after which subcortical structures are also involved. In addition to impaired consciousness and the patient’s transition into a coma, the following develop:

pathological grasping and defensive reflexes;

psychomotor agitation in the intervals between attacks of convulsions, the latter are of the epileptic type and occur with a predominance of muscle hypertonicity;

widespread (generalized) repeated seizures.

Group of the most dangerous symptoms

They are associated with the continued increase in cerebral edema and dislocation of its structures, followed by herniation or pinching in the area of ​​the foramen magnum. Signs include:

Coma (various degrees).

Hyperthermia (above 40 degrees), it cannot be controlled with antipyretics and vasodilators. In some cases, a slight decrease in temperature can be achieved only by applying cold to areas of large vessels or by performing general hypotremia.

There are different pupil sizes and lack of reaction to light, floating eyeballs, strabismus, unilateral convulsive contraction of the extensor muscles and unilateral paresis, absence of tendon and pain reflexes, heart rhythm disturbances, and a tendency to reduce the number of heart beats.

If the patient is not subjected to artificial ventilation, the depth of breathing and frequency first increase, then the breathing rhythm is disrupted, and as a result, respiratory and cardiac activity stops.

Diagnostics

In an outpatient setting, it is quite difficult to diagnose cerebral edema, since the phenomenon does not have any specific neurological symptoms. In the early stages, the complication may be asymptomatic or minimally symptomatic. The diagnosis is made based on the symptoms of the underlying disease or injury that caused the swelling; an examination of the fundus is also informative.

If cerebral edema is suspected, the patient should be kept in the neurosurgery or intensive care unit. In a hospital setting, a decision is made regarding the need to perform a lumbar puncture and angiography. In the diagnostic process, CT and MRI are also informative, which help diagnose edema and determine the degree of its prevalence and severity.

Consequences of cerebral edema in children and adults

The earlier this pathological condition is diagnosed and intensive medical care is provided, the higher the chances of a full recovery. In the intensive care unit, restoration of blood supply to the brain, dehydration therapy, and restoration of liquor dynamics are carried out; the prognosis depends on the severity of the pathology.

In the presence of small perifocal edema, complete recovery is possible, whereas with the development of cystic-atrophic processes in the brain tissue, only partial restoration of functionality can be achieved. When treating only the underlying pathology, which is accompanied by cerebral edema, recovery is not always possible, and a high risk of death remains.

The success of therapy and the consequences for the patient depend on the severity of the pathology that provoked the development of such a serious condition and the degree of edema itself, which in some cases ends in complete recovery. In severe cases, the following are observed:

When the edema is localized in the medulla oblongata, the location of the main life support centers, the consequences of cerebral edema can be impaired blood supply, epilepsy, convulsions, and breathing problems.

Even after appropriate treatment, the patient may experience increased intracranial pressure, which greatly worsens the patient’s quality of life, as it is accompanied by headache, drowsiness, lethargy, decreased social communication skills, loss of patient orientation in time, and disturbance of consciousness.

Infringement of the brain stem is especially dangerous; its displacement is also dangerous, which threatens the development of paralysis and respiratory arrest.

After therapy and a course of rehabilitation, many patients have residual adhesions between the meninges, in the cerebrospinal fluid spaces or in the ventricles of the brain. This also provokes the development of headaches, depression, and disorders of neuropsychic activity.

With prolonged cerebral edema without appropriate therapy, brain function disorders may subsequently occur, which are manifested by a decrease in a person’s mental abilities.

Children may also experience complete recovery or:

mental retardation and neuropsychic instability;

impaired motor coordination and speech;

dysfunction of internal organs and epilepsy;

development of hydrocephalus and cerebral palsy.

Cerebral edema is a serious, in most cases extremely severe, pathology that requires immediate diagnosis, adequate treatment and observation in adults by a psychoneurologist and neurologist, and in children by a neurologist and pediatrician. The duration of observation and therapy after suffering from cerebral edema depends on the severity of residual pathology.

Cerebral edema (CE) is a dangerous complication that progresses due to the development of certain cranial diseases. This abnormal process is characterized by an immense accumulation of intracellular fluid in brain cells. That is, decompensated microcirculatory disorders of the internal structures of the organ occur.

When there are actively developing focal pathological lesions in the brain, which are extremely difficult to treat, the function of self-regulation of vascular tone begins to work incorrectly, which causes rapid dilation of blood vessels. Diffuse swelling of cerebral vessels instantly spreads to healthy areas and initiates an increase in pressure in them.

These pathological modifications end in the fact that the vascular walls lose their usefulness and are unable to retain the watery components of the blood, which, under the influence of high pressure, leak through them into the brain tissue. The internal structures of the brain are gradually saturated with blood fluid, and each cell of the organ increases several times.

Since the brain space is limited by the intracranial cavity, such deformations cause metabolic dysfunction, as well as complete/fragmentary disruption of the functioning of the brain.

The patient experiences a disorder of consciousness, and overall health deteriorates sharply. If you do not provide the patient with prompt and adequate medical care, the GM will completely cease to function, which in turn can lead to death.

Cerebral edema - classification

Depending on the etiology of the pathological course, there are four main types of cervical edema:

Vasogenic cerebral edema

Usually develops as a result of traumatic brain injuries, encephalitis, with incorrect blood microcirculation, various formations (cancerous/benign) in the structure of the organ, hemorrhagic strokes, etc. It is characterized by high capillary permeability and BBB dysfunction, due to which vascular fluid penetrates beyond the boundaries of the walls and fills the white matter.

Cytotoxic

Formed during head injury, hypoxia and ischemia of the brain. Cytotoxic edema develops rapidly and is localized in the gray matter of the brain. This type is characterized by swelling of neurons, glia and endothelial cells. The activity of the cell membrane is disrupted, sodium accumulates in large quantities in the brain cells and, under the influence of osmotic pressure, water penetrates into the internal space of the cellular structures.

Interstitial

Occurs with hydrocephalus, otherwise this disease is called “dropsy”. The normal outflow of cerebrospinal fluid in the ventricles is disrupted, and therefore their activity increases and internal pressure increases. Under the influence of the latter, excessive filtration occurs, accumulation of fluid and low molecular weight substances in the brain.

Osmotic

Abnormal changes affect the osmotic vector between the osmolarity of blood plasma and the osmolarity of brain tissue. Osmotic edema of the brain is especially pronounced in patients with acute organ damage and patients with renal failure.

Causes of cerebral edema

The key factors that act as sources of the painful condition include:

1. TBI – mechanical damage to the bone and tissue structures of the brain leads to the formation of intracranial hematomas, swelling, which prevents the release of accumulated fluid outside the brain tissue.
   Ischemic stroke - occurs when cerebral circulation is impaired. Almost no oxygen enters the organ cells, and they gradually begin to die.
2. Hemorrhagic stroke.
3. Infections – mumps, influenza, measles, encephalitis, meningitis, etc.
4. Malignant tumors.
5. Changes in altitude - scientists have found that at an altitude of 1.5 kilometers above sea level, swelling of the brain can develop (this means a rapid increase in altitude without the body getting used to it).
6. Intoxications of an endogenous nature, formed as a result of severe diabetes mellitus, liver dysfunction, acute renal failure.
7. Poisoning with drugs/poisons.
8. Alcoholism.
9. Allergies – Quincke's edema, anaphylactic shock.
10. In infants, the cause of cervical edema can be severe toxicosis in a pregnant woman during gestation, hypoxia, or skull injuries received during childbirth.
11. Brain swelling after stroke

GM swelling after stroke

This is an almost inevitable phenomenon. Most often, pathology occurs in the presence of tumors in the brain. Characterized by the accumulation of fluid in nerve cells. The following signs may indicate the formation of swelling of the brain after a stroke:

• sharp pain in the head;
• causeless vomiting;
• dysfunction of the visual apparatus or partial loss of functions of other senses;
• disorientation in space;
• rapid breathing, palpitations, shortness of breath;
• stupors;
• cramps in the limbs;
• fragmented memory loss;
• dizziness;
• periodic loss of consciousness.

The last symptom is extremely dangerous with swelling of the brain, as it can provoke coma.

Swelling of the GM after surgery

Occurs as a consequence of postoperative complications. Usually appears within 24 to 72 hours after surgery on the organ. Rapid development, failure of preventive measures after surgery and diagnostic problems can provoke coma.

In order to prevent the formation of edema, the patient must be given corticosteroids and fluid drainage in the first three days.

Alcoholic cerebral edema

Long-term consumption of alcohol-containing drinks over time leads to the destruction of brain cells and the formation of edema. In addition to the symptoms characteristic of the disease, the patient’s physique is noticeably different (large belly, thin arms/legs), and he periodically sees visual hallucinations. There is persistent swelling on the face, the skin peels and has a pronounced bluish tint.

GM swelling due to allergies

Allergic swelling of the brain can be caused by various factors (taking certain medications, eating highly allergenic foods, insect bites, etc.). With this type of pathology, the patient’s condition instantly (within several hours) worsens, and phenomena such as:

1. headache;
2. fear of light and sound;
3. numbness of the occipital region (with this condition it is impossible to press the chin to the chest);
4. vision and speech deteriorate;
5. nausea, in rare cases vomiting is possible;
6. numbness of arms and legs;
7. paralysis.

Symptoms

Symptoms of the pathological process increase gradually as intracranial pressure increases. Common signs of cervical edema in adults include:

• sharp pain in the head that cannot be relieved even with the help of strong antispasmodics;
• constant feeling of nausea;
• vomiting (does not depend on meals and does not bring even short-term relief);
• partial/complete loss of hearing and vision, a feeling of constriction in the eyeballs;
• shortness of breath;
• arrhythmia;
• the patient is poorly oriented in time and space, looks lost, is vaguely aware of real events;
• seizures;
• speech disorder;
• neurology – sleep disturbance, sensitivity, muscle tone, fainting, lack of appetite, tremors, etc.;
• visual hallucinations;
• cerebral palsy, paresis;
• loss of consciousness – as edema progresses, the frequency and duration of attacks increases; in severe cases, a person may fall into a coma.

If a patient exhibits signs of cerebral edema and his condition worsens every day, immediate correction of metabolic disorders is required.

Diagnosis of pathology

An experienced neurologist can detect swelling of the brain at the stage of interviewing the patient or his relatives. To assess the extent of the lesion, the specialist will additionally prescribe an MRI and CT scan of the brain and bone marrow. To establish the actual cause of the formation of a pathological condition, the following is carried out:

1. blood chemistry;
2. lumbar puncture (sampling is carried out extremely rarely, as this may cause
3. additional harm to the patient’s health);
4. other neuroimaging studies at the discretion of the physician.

Treatment

Correct treatment of cerebral edema can be carried out only after identifying the source of the pathology. The main therapy is aimed at eliminating organ dehydration. Certain medical procedures are also performed to relieve the root cause and associated manifestations.

If conservative treatment methods do not produce positive results, then doctors decide on the advisability of surgical intervention (removal of the source of swelling) and trephination of the organ.

Mountain cerebral edema, or resulting from a mild head injury, often goes away on its own, but the patient should always be under 24-hour medical supervision. In such cases, it is necessary to ensure correct blood circulation in the organ to sufficiently saturate the cells with oxygen.

Emergency care for cerebral edema

If any manifestations of cerebral edema appear, you should immediately call an ambulance. Before the doctor arrives you should:

1. place the patient on his back on a flat surface;
2. give him sedatives to drink, as well as medicine to lower blood pressure;
3. cover your head in a circle with ice packs or other items from the refrigerator;
4. open all the windows in the room.

Ambulance workers must carry out urgent hospitalization in a neurological hospital, where the patient will immediately be given intravenous glucose, piracetam solution, Lasix and glucocorticoids. In addition, he will be wearing an oxygen mask to prevent oxygen starvation of the brain. Subsequently, the patient is sent to the intensive care unit or toxicology department according to indications.

Drug therapy

To effectively treat swelling of the brain, complex drug treatment is carried out:

1. Dehydration therapy. Aimed at removing excess fluid from brain tissue.
2. Infusions using loop and osmotic diuretics, hyperosmolar solutions and other drugs that have a stable diuretic effect are indicated as therapeutic procedures.
3. Oxygenation and improvement of metabolism of brain structures
4. Using these methods, it is possible to achieve restoration of metabolic processes in organ tissues, cell regeneration, stabilization of membrane structures and strengthening of the vascular wall.
5. The patient is given invasions of drugs such as Actovegin, Ceraxon, Cortexini hormones of the glucocorticoid group.
6. Elimination of the cause and relief of accompanying symptoms

Since swelling of the brain always occurs with pronounced manifestations, doctors simultaneously eliminate the existing symptoms along with the main treatment. To solve this problem, antibacterial therapy is often used, and medications are prescribed to detoxify the body.

Surgical removal of lesions is possible only after stabilization and improvement of the patient’s general condition.

Consequences

Even after complete cure of swelling of the brain and removal of the affected areas of the organ, patients rarely manage to return to normal life. There is a great danger of complications and the formation of undesirable consequences in the form of:

• systematic headaches;
• sleep disorders;
• speech, visual and mental abnormalities;
• facial asymmetry;
• strabismus;
• epileptic seizures;
• motor dysfunction.

Prognosis for recovery and survival

Toxic and “mountainous” edema of the brain are the least dangerous for humans, and usually respond well to treatment, provided that the patient was taken to the department on time.

For swelling of another origin, the success of therapy depends on the degree of neglect of the pathology. In the early stages of the disease, the painful condition is reversible. As the pathological process progresses, the chances of a full recovery rapidly decrease, and even with the effectiveness of treatment procedures, it will not be possible to restore proper functioning of the brain.

Formed comatose states often cause the death of the patient. It is almost impossible to bring a patient out of a coma with significant organ damage.

In any case, if it was possible to achieve regression of symptoms and elimination of swelling, then patients may subsequently experience residual effects after suffering swelling of the brain. These include:

• frequent headaches;
• depression;
• sleep pattern disorder;
• forgetfulness;
• inattention;
• increased intracranial pressure, etc.

In severe situations, mental disorders, motor and cognitive dysfunctions are observed, which threaten the person with disability.

Brain swelling- a disease that is accompanied by a violation of the outflow of cerebrospinal fluid. In this case, increased pressure appears on the brain tissue. There are problems with blood circulation. If the pathology is not removed in a timely manner, the disease will end in death. Therefore, it is important to know all the symptoms of cerebral edema and how to treat it.

Edema is a complication of various pathologies in the skull. The substance from the vascular space is absorbed into the brain tissue. In this case, not just one lobe is damaged, but the entire brain. But it spreads from one source. Cerebrospinal fluid is released more actively.

You can notice swelling on the first day. The pathology develops as quickly and suddenly as it appears. Therefore, it is extremely important to have an idea of ​​what cerebral edema is. The work of nerve cells and the functionality of the nerve center are disrupted. The cells become enlarged as water enters them and binds with proteins.

The structures are then completely damaged, leading to consequences that may be irreversible. Sometimes swelling can quickly go away on its own, without leaving a single trace. This happens in the case of a mild concussion.

Types of edema

Liquid can accumulate for various reasons. Depending on these reasons, different types of cerebral edema are distinguished.

The vasogenic form is the most common. The cause of swelling is damage to the blood-brain barrier. The white matter increases, which creates a lot of pressure. The substance most often accumulates in damaged areas of the brain

Edema, puffiness and swelling of the brain may be cytotoxic in nature. In this case, the swelling appears from the gray matter. The disease can occur after ischemia, hypoxia, intoxication and other reasons.

Osmotic edema or swelling of the brain appears if the osmolarity of the tissues of the nervous system is at an elevated level. The reasons may be complications after other diseases, or improper treatment or cleansing: after hypervolemia, polydipsia, metabolic disorders. Swelling may also occur if the blood is not cleaned correctly.

Interstitial cerebral edema often occurs. Occurs when cerebrospinal fluid from the ventricles escapes through the walls of the cavity. This is a direct disruption of the functioning of the nerve center, in which tumors can play their role.

Also, edema varies in the scale of the pathology. There may be local and generalized swelling. Local is also called regional. Its distribution is limited by a certain border. This may include hematomas, tumors and other formations.

Generalized edema spreads throughout the cranium around the brain. There are many reasons why such a pathology can arise. Among them are traumatic brain injury, impaired functionality due to the exclusion of air from the brain, intoxication, and many other reasons. Even high blood pressure can lead to the formation of pathology.

What can cause swelling?

Signs of cerebral edema are usually immediately noticeable, as it usually appears after an illness or injury. Therefore, education may be suspected. There are 8 main reasons that have a beneficial effect on the formation of puffiness. The causes of cerebral edema are as follows:

1. Often the pathology occurs after a traumatic brain injury. The difficulty is that injuries damage soft tissue. Most often there is swelling of the brain after surgery. The endoscopic method of the operation does not exclude the appearance of swelling as a consequence. The function of the musculoskeletal system is impaired, and paralysis of the limbs is possible.
2. Infection. The inflammatory process damages nerve endings and cells, which causes tissue swelling. Such an infectious disease can be meningitis, encephalitis, empyema and other acute diseases. If the disease is accompanied by the release of pus, swelling develops faster with greater consequences for the body.
3. Tumor. Swelling can be caused by both benign and malignant tumors. The formation puts pressure on soft tissues, thereby damaging them. Due to irritation, natural swelling occurs. After the tumor is removed, the swelling quickly goes away.
4. Internal hemorrhage in the head. A ruptured artery causes tissue inflammation, which in turn causes swelling of the brain.
5. Ischemic stroke. A blood clot appears in the arteries, as a result of which the cells do not receive oxygen and die. Cerebral infarction causes necrosis, which is accompanied by swelling.
6. Intoxication. Poisoning causes cell death and damage to body tissue. This has a positive effect on the formation of swelling. Incorrectly administered anesthesia also causes intoxication, which can lead to the formation of edema.
7. Birth injury. During childbirth, various injuries to the newborn baby can occur. The fetus can also be crushed by the umbilical cord. Hypoxia can be complicated by edema.
8. Atmospheric pressure surges. People who work at heights or depths are susceptible to swelling. The difference in external pressure causes an increase or decrease in intracranial pressure. Those prone to swelling include pilots, mountaineers and scuba divers.

Diagnostics

The first step is to check with a neurologist. Treatment begins with this. If the patient's condition steadily worsens, the doctor has the first suspicions. Symptoms of meningitis may also indicate the development of edema.

The final answer to the question of the presence of swelling is given with the help of MRI or CT. To get a complete picture, you need to conduct a blood test, neurological status, and determine possible factors that contributed to the formation of the pathology.

Cerebral edema develops quite quickly, so the test should not be postponed. Treatment and diagnosis are best carried out in a hospital setting.

Symptoms

Cerebral edema has symptoms like other pathologies in the skull. General cerebral symptoms, as well as individual signs, are necessarily present. Symptoms are influenced by all features of education:

• development period;
• localization;
• speed of development;
• scale and others.

If the number of symptoms increases, it is suspected that the swelling is damaging different parts of the brain. In this case, it is necessary to immediately begin treatment.

Signs of cerebral edema– these are symptoms of high blood pressure, neurological manifestations and indicators of the patient’s critical condition, such as coma and others.

Increased cranial pressure is always accompanied by headache and fatigue. The patient becomes easily excitable. Consciousness gradually becomes cloudy, nausea turns into vomiting. Sometimes cramps may occur, which accelerate the growth of swelling. There are problems with the direction of eye movement.

Symptoms of cerebral edema caused by diffuse disorders are dangerous. Damage to the nervous system leads to a state of coma. Consciousness is impaired, with possible mild delirium. The convulsions are not isolated, they recur periodically. Epileptic-type seizures may occur. Incorrect functionality of reflex centers.

Swelling of the brain can have consequences that cannot be reversed. If the substance gets into the hole in the occipital lobe, serious damage to brain structures can occur. The patient may enter a deep coma. You may experience a fever that is not helped by antipyretic medications. To reduce the temperature, you need to cool the large vessels that are closest to the skin. The reaction of the pupils is inhibited, and one may be larger than the other. Children often develop strabismus. Heart rate drops sharply.

In case of critical condition, the patient must be connected to an artificial respiration apparatus so that the consequences of cerebral edema are not fatal. The breathing rate increases unstably, leading to its eventual stop.

First aid

After the first signs of tissue swelling appear, you need to prepare for a set of first aid measures, which can play a big role.

If the symptoms are already pronounced, it is imperative to provide a flow of clean air. Make sure that no vomit enters the respiratory tract. You can cool your head with ice packs. This method allows you to dilate blood vessels for normal blood circulation. If possible, the patient should be given an oxygen mask. The product plays a significant role in saving lives.

After assistance is provided, the patient should be quickly transported to the hospital. The position of the head and body should be horizontal.

Medical treatment of pathology

If inpatient treatment is not carried out in time, the consequences of cerebral edema may be irreversible. The goal of medical care is to stabilize the metabolic processes of the brain. The complex of therapeutic actions consists of a combination of surgical intervention and drug treatment.

Useful to know: Cerebral vasospasm: symptoms, signs, recommended treatment

First, doctors will ensure the flow of oxygen to the brain. For this purpose, artificial oxygen supply devices are used. Oxygenated blood helps to quickly reduce brain swelling.

Drugs that help reduce cranial pressure are administered through a dropper. They can also inject solutions that can reduce body temperature, which also helps resolve swelling.

There may be a situation where traditional measures are not enough to completely get rid of swelling. A catheter can remove some of the fluid in the cerebral ventricles. Sometimes blood vessels require repair. For this, a surgical method is used. In the most extreme cases of increased cranial pressure, part of the skull may be removed. The operation is quite serious and complex.

Restoring brain function after treatment

The severity of possible complications directly depends on how quickly treatment is started. Over time, the cells that surround the damaged part will perform the same functions. But this takes a lot of time. Sometimes recovery can be done on an inpatient basis. After a stroke, the patient can learn to talk and walk again.

Remedial measures prevent fluid accumulation from reoccurring. Doctors prescribe medications that help quickly restore the functionality of parts of the brain. The sooner treatment begins, the fewer consequences there will be after recovery.

Consequences

Brain edema is always accompanied by consequences that may not always be serious, but can sometimes be fatal. The pathology is unpredictable, so for treatment you need to contact only a highly qualified doctor. There are three possible developments after swelling:

• further progression of the pathology with a fatal outcome;
• removal of edema resulting in disability;
• complete removal of swelling without consequences.

Unfortunately, about 50% of cases of edema are fatal. This is influenced by the causes of cerebral edema and its treatment. When the amount of fluid is critical, the cerebellar tonsils deepen into the brain stem, which causes the heart and breathing to stop.

Minor swelling following a concussion or other similar damage can be successfully and completely eliminated. Timely access to the hospital plays a big role in this scenario. Typically, full recovery is possible after cerebral edema in adults who are somatically healthy with a strong immune system.

Often, the disease that occurs can damage brain tissue in such a way that the consequences of improper functionality cannot be eliminated. Meningitis, traumatic brain injuries and hematomas can have such consequences. The nerve cells of the brain die off completely, and the neighboring ones cannot perform a large number of functions. In this case, the patient’s life is saved, but with subsequent disability.

Infections and injuries often affect the brain. Some bacteria tend to penetrate the barrier of the nervous system created to protect it. And injuries cause other reasons, leading to a dangerous complication - swelling of the brain tissue.

Cerebral edema is not a primary disease. It is a pathological condition that develops as a result of pathological changes caused by other diseases. This is a kind of reaction of the body to negative influences.

The acid-base balance is disrupted, the total amount of fluid inside the skull increases, which leads to a pathological increase in intracranial pressure.

Consequences after treatment depend on the timing of its initiation, the correct approach and the severity of the primary injury. Full recovery is possible.

Various neurological disorders may appear: convulsions, epileptic seizures, paralysis of the limbs and other sensory disorders. Headaches, states of depression and depression, mental disorders can haunt a person for a long time due to the unfavorable outcome of the pathology.

Types of Edema

Edema of brain formations is divided into: central location and peripheral.

Peripheral swelling is swelling of the spinal cord of the spine. And the central location, the brain substance itself.

The edematous condition of the central location is usually divided into 2 types. Swelling of part of the brain (regional) and all central brain cells (widespread). Each type is caused by different reasons.

Causes of swelling

A pathological increase in the volume of the brain matter can be caused by various reasons, including: trauma, infectious lesions, tumors, vascular pathologies.

Regional swelling can usually be caused by diseases and conditions that affect only a small part.

1. Tumors, cancer diseases;
2. Cystic formations;
3. Blood tumors due to injury;
4. An abscess due to an infection that has entered the brain.

The causes of a widespread increase in the volume of the brain matter include various diseases, poisoning, consequences of drowning, suffocation, and other injuries.

There are many reasons that can create both local and widespread swelling of the brain tissue.

1. Skull and brain injuries, bruise after injury;
2. Strokes and cerebral hemorrhages often occur in older people;
3. Neonatal cerebral edema due to trauma during childbirth;
4. Severe allergy attack;
5. Epilepsy, heat stroke in childhood,
6. Preeclampsia in the second half of pregnancy with a severe outcome;
7. Severe infections: encephalitis, meningitis, mumps, toxoplasmosis;
8. Many operations during which there is intervention in the cranial cavity cause edema. For example, swelling may occur after removal of a brain tumor.

Dangers of Edema

Delayed diagnosis and improper treatment can lead to severe disturbances in the vital functions of breathing and heartbeat. Which lead to death. Severe, permanent neurological damage may occur, such as a violation of the motor and sensory activity of the limbs.

Timely provision of assistance will allow you to avoid these violations. In order to quickly receive qualified help, you need to know the symptoms of this condition.

Symptoms and manifestations

Signs of cerebral edema are conventionally divided into several groups.

• Symptoms of increasing intracranial pressure;
• Neurological manifestations;
• Symptoms of growing swelling of brain cell formations and their infringement.

Symptoms of increasing intracranial pressure are manifested by the following signs:

• Increasing headache with a feeling of fullness;
• Signs of lethargy and drowsiness appear;
• In the midst of complete rest, vomiting appears;
• The development of intracranial hypertension leads to impaired eye movement, and vision periodically deteriorates.

Neurological symptoms begin to develop due to the spread of edema to the cortex, then to the subcortical formations. The pressure inside increases, this leads to the following disorders.

• Impaired grasping and defensive reflexes. Pathological reflexes appear that are characteristic only of newborns, etc.
• Attacks of convulsions followed by psychomotor agitation.
• The spasms increase and take over the entire body.

When swelling grows and treatment has not yet begun, severe irreversible damage to the nervous tissue occurs.

1. Disturbances in the centers of breathing and heartbeat, resulting in death;
2. Unilateral severe neurological damage, due to compression of the medulla on one side. One eyeball is dilated, loss of reflexes, paralysis of the limbs on one side.
3. Temperatures rise to 40C and above. She can't be shot down.
4. The patient becomes seriously ill - coma.

Coma due to cerebral edema

Coma is characterized by a state of deep pathological sleep. The functioning of the nervous system slows down and is disrupted. A person is unconscious and does not respond to external stimuli or pain. Vital functions are impaired.

Staying in a coma for a long time leads to the death of many nerve cells, resulting in death.

Features of cerebral edema in a newborn

The peculiarity of brain swelling in adults is that it most often increases more slowly than in children. The development of edema in a newborn occurs very quickly and requires thorough knowledge of emergency care, skills in diagnosis and treatment. Most often in children, swelling of the brain stem occurs.

Swelling of nerve tissue in newborns occurs due to several reasons.

• Birth injuries are the most common and common cause of swelling.
• Toxic lesions of the fetus;
• Genetic disorders.

With adequate timely therapy, the nerve cells are restored and the swelling subsides. Severe course entails various consequences, including:

1. Delayed growth and general development of the child;
2. Epileptic seizures;
3. Paralysis;
4. Dropsy of the medulla;

Diagnosis of edema of brain structures

The doctor begins diagnostic measures with a general examination, questioning of complaints (if the patient is conscious). If unconscious, a survey of relatives and personnel who were present at the time of the onset of clinical manifestations is conducted.

After this, the patient is referred for additional diagnostic methods.

Injuries require examination of the skull using x-rays. To assess the severity of bone injuries. Assess skull damage.

Afterwards, computed tomography and magnetic resonance imaging are prescribed to assess the spread of swelling.

The picture shows cerebral edema:

Due to hematoma: a. On CT; B. On MRI.

Due to the accumulation of fluid in the brain tissue, pressure occurs inside and swelling occurs.

Treatment of cerebral edema

Brain edema is a serious condition of the body that requires urgent intervention, regardless of where the swelling began, at home or in a medical facility. After urgent measures, the nervous tissue is saturated with oxygen, the amount of fluid in the body is reduced in various ways, and the temperature is lowered.

Urgent Care

Emergency care before the arrival of doctors includes several measures designed to reduce the severity of the condition.

It is necessary to cover the person's head with ice packs to reduce the temperature. Provide him with adequate breathing if there is vomit or other liquids in his mouth. It is necessary to free him from these liquids. Next, it is necessary to provide enough fresh air; a person in this state needs an increased amount of oxygen.

Sometimes the doctor may decide to perform surgery to reduce intracranial pressure. Craniotomy is performed to drain fluid accumulated inside the skull or shunting to create drainage conditions.

Dehydration therapy

Dehydration is the removal of water from the body. It is carried out to reduce the amount of excess fluid. To remove fluid from the body, the use of osmodiuretics is indicated. Prescribed drugs such as mannitol, sorbitol, glycerol.

Mannitol is administered intravenously, briefly reduces ICP, and removes water through the kidneys, due to the creation of increased plasma osmolarity. Sorbitol is much weaker in action than mannitol, and glycerol has the same effect as mannitol.

Other drugs in the treatment of cerebral edema

In addition to dehydration agents, several other groups of drugs are used to reduce swelling.

Corticosteroids normalize the pathologically increased vascular permeability in the area of ​​swelling. Restore normal blood flow to the affected area. Group representative: Dexamethasone.

Barbiturates are a class of drugs that reduce swelling of the brain and reduce the number of seizures. This increases the chances of a favorable outcome for the patient.

Adequate oxygenation and improved brain metabolism

The patient is transferred to artificial ventilation. Maintain partial oxygen pressure at 100 mm. Hg Art. Hyperventilation of the lungs is carried out, which reduces swelling by narrowing the lumen of blood vessels. Ensuring constant access of oxygen to the brain prevents the development of complications associated with its deficiency.

Treatment aimed at eliminating the cause and associated symptoms

Edema of the brain structures is not a primary disease. In order to quickly survive the crisis, the patient needs adequate treatment of the underlying pathology.

Treatment of infectious diseases such as meningitis and encephalitis requires the use of antibiotics aimed at destroying the pathogen. A calm environment is created for the patient to reduce the impact of external factors.

Swelling due to exposure to a strong allergen requires elimination of the allergic exposure.

In case of injuries, surgical treatment of traumatic injuries is often resorted to. Hematomas are removed, broken parts of bones are put in place, and fragments are removed.

Tumors require mandatory surgical removal, if possible.

Treatment with folk remedies

Folk remedies, along with medications, can have a diuretic effect, which promotes the removal of fluid. As well as restoring normal blood circulation in the vascular bed, reducing intracranial pressure.

To reduce intracranial pressure, you need to take 30 g of flowers of sand cumin, adonis, leaves with Sophora flowers. 50 g each of tribulus herbs, yarrow, St. John's wort, parsley seeds, elderberry flowers. 100 g of Goldenrod herb, leaves from the White Birch tree. Grind the collection, brew one and a half tablespoons per 300 ml of boiling water. Leave for 6 minutes. Add honey, one tablespoon. Drink half a glass half an hour before meals, treatment lasts 1.5 months.

To reduce symptoms such as tinnitus, unsteadiness of gait, pressure surges, headaches, frequent dizziness, memory impairment, and loss of strength, the following collection is used.

Take rhizomes of valerian, rose hips, calamus, licorice, and marshmallow. Sunflower, motherwort, wheatgrass, mint, elecampane. Prepare and use all this in the same way as in the first recipe.

It is important to remember that treatment with herbs and other remedies can be started after consultation with a specialist.

Consequences and complications of edema of brain structures

There are favorable and unfavorable outcomes. Favorable ones include complete recovery and recovery with a minimum of complications.

Mild complications: Insomnia, depression, decreased physical activity, headaches.

Adverse outcomes are characterized by severe neurological impairment or death.

Progression of edema with transformation into brain swelling and death

If treatment is not timely, the chances of survival are reduced. Swelling or perifocal edema of the brain occurs. This is a condition in which fluid begins not only to put pressure on the cells, but also to accumulate in them, increasing the pressure. The space of the ventricles of the brain is compressed. A deep coma develops.

This complication certainly leads to death or ends in severe complications. Brain swelling can also occur after major brain surgery.

Elimination of edema with disability of the patient

Swelling of brain structures or delayed treatment leads to complications that make normal human functioning difficult. The need for disability is raised for such patients.

Such complications include:

• Lifelong partial loss of motor activity of the limbs;
• Permanent loss of speech;
• The occurrence of dementia;
• Schizophrenia due to depression.

Complete elimination of edema without consequences

A similar situation is possible if treatment is started in a timely manner, and the severity of the primary pathology does not aggravate the process and organic damage to the brain tissue does not occur. For example, due to injury or massive stroke.

Sometimes complications appear that leave no trace over time.

• Headaches that go away after a few months;
• Emotional disturbance;
• Mild movement disorders;

The outcome of a disease with such complications is considered an outcome without consequences if they disappear after some time. A completely favorable outcome is very rarely possible.

Brain recovery after edema

After an illness, the patient needs a calm environment. It is worth limiting him from mental trauma, if temporary movement disorders occur, and providing the necessary care and support. Take vitamin complexes and special products prescribed by your doctor to strengthen your memory.

Severe movement disorders after treatment require proper social adaptation. Relatives can help with this. Often a person cannot get used to a change in his social status. It is necessary to help a person find positive aspects, to show an incentive to live on. You can contact a psychologist.

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

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

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.

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?

How does cerebral edema manifest?

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?

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

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

1. Toxicosis.
2. Hypoxia.
3. Genetic predisposition.

1. Developmental delays.
2. Hyperactivity.
3. Epilepsy.
4. Paralysis.
5. Hydrocephalus or dropsy.
6. Vegetative-vascular dystonia.

How and with what to relieve cerebral edema

Diagnosis of cerebral edema

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

Medicines for swelling

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

Treatment of cerebral edema with folk remedies

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

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.