Causes and symptoms of cerebral edema

Shoshina Vera Nikolaevna

Therapist, education: Northern Medical University. Work experience 10 years.

Articles written

Cerebral edema is one of the most dangerous diseases, often leading a person to death if medical assistance was not provided on time.

What is cerebral edema? Why is he dangerous? Edema of the brain of the head is a condition in which the normal circulation of cerebrospinal fluid (cerebrospinal fluid) is disturbed, which occurs in people due to trauma (for example, a bruise of the head), certain infections or pathologies. The condition is characterized by the following features: a sharp increase in CSF pressure in the brain, which can lead to irreversible necrotic changes in tissues and even death. Only timely decongestant therapy gives a chance to survive in this situation.

What is this disease

In a healthy person, cerebrospinal fluid circulates smoothly throughout all parts of the brain. It is she who is responsible for supplying brain tissues with oxygen and nutrients, and serves as additional protection against damage to the internal parts of the brain as a result of mechanical injuries. The amount of cerebrospinal fluid circulating in the internal parts of the brain is also responsible for intracranial pressure. A slight increase in fluid pressure on the brain tissue during coughing or heavy lifting does not pose any threat to the body.

But in the presence of a negative factor (with diagnosed tumors in the brain tissues, infectious diseases), a sharp increase in the volume of cerebrospinal fluid can occur, which leads to a persistent increase in pressure inside the cranium and, as a result, to swelling of the brain tissues. Symptoms of the disease appear very quickly. The patient's condition may worsen every minute. If cerebral edema is not removed in time, the prognosis for survival is not very bright.

Causes of cerebral edema can be as follows:

Infection of brain tissues with viruses, bacteria, which develops in diseases such as meningitis, brain abscess, encephalitis.
Entry into the body of toxic substances.
Complications that can cause some diseases (flu, purulent tonsillitis, inflammation of the maxillary sinuses, otitis media), accompanied by the development of purulent-inflammatory processes in tissues adjacent to the brain.
The presence of mechanical injuries of the skull, accompanied by hemorrhages and the formation of intracranial hematomas. Swelling of the brain in some parts of the skull.
Formation in the brain, which leads to compression of the nervous tissue and blood vessels responsible for the normal flow of cerebrospinal fluid, which causes swelling and swelling of the brain.
The presence of birth trauma. Pathological changes that occurred during the formation of the fetus due to various diseases suffered by a pregnant woman.
Strokes and infarctions of the brain with a pronounced ischemic and hemorrhagic type.
An allergic reaction of the body, accompanied by swelling of the brain tissue.
Complications in renal or hepatic insufficiency.
Complications of alcohol poisoning (withdrawal syndrome).
When climbing to a considerable height, there is also swelling of the brain, called "mountain edema."

Having found out the causes of cerebral edema, it is necessary to dwell in more detail on the classification of types of tissue swelling.

Classification of disease types

The international classification of diseases contains detailed descriptions of the signs of edema and the mechanism for the development of edema. The division by type makes it possible to conduct a quick diagnosis, detect pathological changes at the very beginning of development, and minimize the negative consequences of cerebral edema.

Doctors distinguish the following types and manifestations of puffiness:

Vasogenic edema is the most common type of the disease.

This cerebral edema develops as a result of disorders in the functional capillary system. With their excessive permeability, the volume of white matter begins to increase. Symptoms can come on quickly, and if there is a head injury, swelling appears within the first 24 hours. Usually, with a vasogenic type of edema, cerebrospinal fluid accumulates in the nervous tissues around swellings and tumor formations, in areas of surgical intervention, injured areas of the brain and its vessels, can be found in the area of the inflammatory process occurring in the brain tissues, or form in the focus where it originated.

This type of swelling can rapidly develop into compression of the brain. Perifocal cerebral edema is one of the subtypes of swelling of the brain tissue, belonging to the vasogenic type. It is formed due to an internal hemorrhage in the brain tissues.

Toxic edema.

This type of swelling mainly occurs under the influence of external adverse factors: exposure to the body of toxic substances (for example: carbon monoxide); a rapidly developing ischemic crisis that occurred due to blockage of blood vessels in the brain; poisoning with chemical compounds and poisons that can destroy erythrocytes (red blood cells). This cerebral edema develops due to an imbalance in the gray matter.

osmotic type.

Puffiness of this type is characteristic of deviations that occur in the ratio of brain tissue and blood plasma. The reasons are often: asphyxia during drowning; improperly performed hemodialysis (blood purification procedure); genetic diseases in which the volume of circulation of blood cells increases significantly; metabolic disorders (renal failure).

Interstitial edema.

Such cerebral edema develops due to fluid penetrating into the brain tissue through the damaged wall of the ventricle. Puffiness can be local (spread in a small area of the brain) or generalized (affect the entire brain).

hydrostatic type.

It can be caused by disorders with a characteristic increase in intracranial pressure. Usually diagnosed in infants, cerebral edema in adults of this type is extremely rare, the cause is trauma or surgery on the brain.

This type of edema develops due to birth trauma (fetal hypoxia, difficult childbirth), complications during pregnancy.

When diagnosing a disease, all the symptoms of cerebral edema and external factors affecting its development are taken into account, on the basis of which the type of swelling is determined.

Symptoms characteristic of the disease

What are the typical signs of cerebral edema, which can be used to detect a formidable disease at an early stage?

A sharp headache is the most typical sign that excess fluid is accumulating in the medulla. Such acute pain can provoke other diseases. But if you have recently received a head injury, pain medication helps only for a short time, nausea and vomiting occur periodically, you should immediately notify your doctor.

General symptoms of cerebral edema, characteristic of all types of swelling, are as follows:

Intense headaches accompanied by dizziness, vomiting, nausea.
A state of distraction, impaired attention, inability to concentrate, a state of forgetfulness.
Sleep problems, constant drowsiness or insomnia.
Mental problems: depressive states, feeling of depression, problems with orientation in time, failures in orientation in space.
Constant fatigue, unwillingness to see anyone, fatigue.
Problems with vision, speech and hearing.
Changed gait, unsteady movements.
Paralysis of the limbs, convulsive manifestations.
A sharp drop in pressure.
Disturbed heart rhythm.
Particularly severe cases are accompanied by confusion, cardiac arrhythmias, malfunctions in the respiratory system, which can cause a person to be in a coma.

If you do not start treating cerebral edema in time, the consequences can be the saddest. After a certain time, the patient falls into a state of stupor, then a coma occurs, which is fraught with respiratory arrest, which leads to death.

What is the danger of the disease

Why is swelling of the brain tissue considered one of the most dangerous diseases? The thing is that it is often impossible to completely cure the effects of swelling, even in cases where the emergency care needed for cerebral edema was provided on time. In any case, when a pathology is detected, the first task of physicians is to relieve symptoms and decongestant treatment, which includes combating the effects of swelling.

The most serious consequences of brain swelling are necrotic processes that develop in cells and soft brain tissues. Complete restoration of dead areas is almost impossible. Depending on the area of the lesion, and what treatment of cerebral edema was prescribed, the patient may subsequently develop the following complications:

On the part of neurology: the presence of chronic headaches, violations in the symmetry of the facial muscles, insomnia, impaired reflex functions.
On the part of the psyche: anxiety, stress, postpartum depression.

Traumatic cerebral edema is dangerous because it can lead to paralysis of the limbs, often cerebral edema obtained after an injury is a direct path to disability.

About coma with cerebral edema

Cerebral edema, if the symptoms indicate a large area of the lesion, can lead the patient into a coma. Why is this happening, how to treat this condition?

An extensive lesion severely compresses the brain tissue. In this case, the algorithm of the body's work is as follows: the protective mechanisms necessary to maintain vital functions come into action. The person first loses consciousness, and later may fall into a coma. This is the protective reaction of the body. Treatment of extensive cerebral edema involves immediate medical attention. Hospitalization is a necessary condition for this type of edema.

How the disease is diagnosed

If the patient has a suspicion of cerebral edema, then the treatment of the disease cannot be carried out at home. The patient should immediately consult a doctor, where he will be assigned a complete examination and adequate treatment.

According to the combination of characteristic signs and symptoms caused by the state of swelling, as well as a number of medical examinations, the doctor prescribes drugs and procedures.

Examinations that are prescribed if edema is suspected:

Magnetic resonance imaging. The examination makes it possible to detect the location of the edema, its size. Helps predict the effect of swelling on the brain.
Computed tomogram. The examination helps to identify the degree of damage to the brain tissue, to find the location. With the help, it is possible to make a preliminary forecast of possible complications.
Blood test. Such an examination allows you to find out if intoxication of the body has occurred.
Puncture. The analysis is taken from the spine, the cerebrospinal fluid is examined to detect infections or cancer.

Treatment, recovery of the body after an illness

Treatment of a patient with diagnosed edema includes the following measures:

Taking drugs prescribed by a specialist. What and how much to take can only be determined by a doctor based on the data obtained. With this type of pathology, the following are usually prescribed: hormonal agents, effective drugs to relieve swelling; drugs that maintain stable blood pressure; diuretic; vascular preparations, etc.
In the most severe case, a craniotomy is performed, which is extremely traumatic for the patient. That is why, in the treatment of puffiness, doctors are reluctant to resort to surgery.
Recovery period. After removing the swelling, specialists carry out a series of actions aimed at the complete restoration of the patient's brain and the prevention of similar situations in the future. The recovery period is extremely important in order to minimize the severity of the consequences. It should be carried out exclusively in a medical institution under the supervision of doctors.

How to help a sick person at home

Can swelling of the brain pass without complications? Yes, if the disease was treated in a hospital, and the patient received timely assistance at home.

If a patient is suspected of having this pathology, relatives should immediately call an ambulance, and before the arrival of doctors, the following should be done:

Lay the patient on a horizontal surface, open all windows for oxygen.
During bouts of vomiting, carefully monitor the patient so that the airways are not clogged with vomit. In this case, you can lay the patient on his side.
Cover the patient's head with ice packs or wrap with a cloth soaked in cold water.
If there is an oxygen mask in the house, put it on the patient.

The sooner the patient is taken to the hospital, the greater the chance that the severe consequences of the disease will be minimized. When self-transporting a patient to a medical institution, the following rules must be observed:

lay the patient horizontally, without putting anything under his head;
place a folded blanket or pillow under your feet;
turn your head to the side to prevent vomit from entering the airways.