A cerebral edema is a pathological condition in which excessive accumulation of water occurs in the tissues of the brain and spinal cord due to disruption of its normal movement and a metabolic disorder.
Causes of cerebral edema can arise as a result of direct effects of the pathological process on the nervous system (trauma, brain tumors, infectious lesions of the brain, spinal cord and their membranes), may accompany certain somatic diseases (general infections, cardiovascular and hepatic diseases, burns, etc..
Types of cerebral edema By pathogenesis, cerebral edema is divided into vasogenic, cytotoxic, interstitial and filtration.
Depending on the etiological factor, distinguish between tumor, traumatic, postoperative, toxic, inflammatory, ischemic and hypertensive cerebral edema.
The main symptoms of brain edema Clinical manifestations of edema-swelling of the brain are the same regardless of its pathogenetic type.
They consist of a combination of three groups of symptoms: due to the syndrome of intracranial hypertension, focal and stem symptoms.
Treatment of cerebral edema One of the main tasks in the treatment of a patient with intracranial pathology in an acute period is to provide him with a normal level of central perfusion pressure (CPD), since it determines the adequacy of blood supply and nutrient intake to the neuron.
The CPD is determined by the formula:.
CPV = mean arterial pressure (SBP) - intracranial pressure (ICP) - central venous pressure (CVP).
Edema of the brain leads to the development of intracranial hypertension, t. an increase in ICP and, accordingly, a decrease in the CPD.
Treatment of edema-swelling of the brain involves the maintenance of oxygenation (pO2> 70 mm. ppm. art..
), if necessary - transfer to the ventilator removal of motor excitement and seizures prevention and elimination of pain and nociceptive reactions removal of causes that disrupt venous outflow from the cranial cavity maintenance of normal body temperature moderate hyperventilation diuretic administration If conservative treatment is not effective, decompression trepanation of the skull, flap for the purpose of reducing the increased ICCH due to edema.
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