Cerebral edema

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Cerebral edema Classification and external resources
ICD-10	G93.6
ICD-9	348.5
DiseasesDB	2227
MeSH	D001929

WikiDoc Resources for Cerebral edema
Articles
Most recent articles on Cerebral edema Most cited articles on Cerebral edema Review articles on Cerebral edema Articles on Cerebral edema in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Cerebral edema Images of Cerebral edema Photos of Cerebral edema Podcasts & MP3s on Cerebral edema Videos on Cerebral edema
Evidence Based Medicine
Cochrane Collaboration on Cerebral edema Bandolier on Cerebral edema TRIP on Cerebral edema
Clinical Trials
Ongoing Trials on Cerebral edema at Clinical Trials.gov Trial results on Cerebral edema Clinical Trials on Cerebral edema at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Cerebral edema NICE Guidance on Cerebral edema NHS PRODIGY Guidance FDA on Cerebral edema CDC on Cerebral edema
Books
Books on Cerebral edema
News
Cerebral edema in the news Be alerted to news on Cerebral edema News trends on Cerebral edema
Commentary
Blogs on Cerebral edema
Definitions
Definitions of Cerebral edema
Patient Resources / Community
Patient resources on Cerebral edema Discussion groups on Cerebral edema Patient Handouts on Cerebral edema Directions to Hospitals Treating Cerebral edema Risk calculators and risk factors for Cerebral edema
Healthcare Provider Resources
Symptoms of Cerebral edema Causes & Risk Factors for Cerebral edema Diagnostic studies for Cerebral edema Treatment of Cerebral edema
Continuing Medical Education (CME)
CME Programs on Cerebral edema
International
Cerebral edema en Espanol Cerebral edema en Francais
Business
Cerebral edema in the Marketplace Patents on Cerebral edema
Experimental / Informatics
List of terms related to Cerebral edema

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Overview

Cerebral edema (cerebral oedema in British English) is an excess accumulation of water in the intra- and/or extracellular spaces of the brain.

Vasogenic cerebral edema

Due to a breakdown of tight endothelial junctions which make up the blood-brain barrier (BBB). This allows normally excluded intravascular proteins and fluid to penetrate into cerebral parenchymal extracellular space. Once plasma constituents cross BBB the edema spreads, this may be quite fast and widespread. As water enters white matter it moves extracellularly along fiber tracts and can also affect the gray matter. This type of edema is seen in response to trauma, tumors, focal inflammation, late stages of cerebral ischemia and hypertensive encephalopathy.

Some of the mechanisms contributing to BBB dysfunction are: physical disruption by arterial hypertension or trauma, tumor-facilitated release of vasoactive and endothelial destructive compounds (e.g. arachidonic acid, excitatory neurotransmitters, eicosanoids, bradykinin, histamine and free radicals).

Cytotoxic cerebral edema

In this type of edema the BBB remains intact. This edema is due to the derangement in cellular metabolism resulting in inadequate functioning of the sodium and potassium pump in the glial cell membrane. As a result there is cellular retention of sodium and water. There are swollen astrocytes in gray and white matter. Cytoxotic edema is seen with various intoxications (dinitrophenol, triethyltin, hexachlorophene, isoniazid), in Reye's syndrome, severe hypothermia, early ischemia, encephalopathy, early stroke or hypoxia, cardiac arrest, pseudotumor cerebri, and cerebral toxins.

Osmotic edema

Normally cerebral-spinal fluid (CSF) and exocoelomic fluid (ECF) osmolality of the brain is slightly greater than that of plasma. When plasma is diluted by excessive water intake (or hyponatremia), syndrome of inappropriate antidiuretic hormone secretion (SIADH), hemodialysis, or rapid reduction of blood glucose in hyperosmolar hyperglycemic state (HHS), formerly hyperosmolar non-ketotic acidosis (HONK), the brain osmolality will then exceed the serum osmolality creating an abnormal pressure gradient down which water will flow into the brain causing edema. It effects the brain so severely that the victim feels like drowning until he/she dies the slow painful death.

Hydrostatic edema

This form of cerebral edema is seen in acute, malignant hypertension. It is thought to result from direct transmission of pressure to cerebral capillary with transudation of fluid into the ECF.

Interstitial cerebral edema

Occurs in obstructive hydrocephalus This form of edema is due to rupture of CSF-brain barrier: permits CSF to penetrate brain and spread in the extracellular space of white matter. Differentiated from vasogenic edema in that fluid contains almost no protein

High Altitude Cerebral Edema

High altitude cerebral edema (or HACE) is a severe (usually fatal) form of altitude sickness. HACE is the result of swelling of brain tissue from fluid leakage. Symptoms can include headache, loss of coordination (ataxia), weakness, and decreasing levels of consciousness including disorientation, loss of memory, hallucinations, psychotic behavior, and coma. It generally occurs after a week or more at high altitude. Severe instances can lead to death if not treated quickly. Immediate descent is a necessary life-saving measure (2,000 - 4,000 feet). There are some medications (e.g. dexamethasone) that may be prescribed for treatment in the field, but these require proper medical training in their use. Anyone suffering from HACE must be evacuated to a medical facility for proper follow-up treatment. A gamow bag can sometimes be used to stabilize the sufferer before transport or descending.

Climbers may also suffer high altitude pulmonary edema (HAPE), which affects the lungs. While not as life threatening as HACE in the initial stages, failure to descend to lower altitudes or receive medical treatment can also lead to death.

External Links

• Altitude.org

• CerebralEdema.com

v • d • e Pathology of the nervous system, primarily CNS (G00-G47, 320-349)
Inflammatory diseases of the CNS	Meningitis (Arachnoiditis) - Encephalitis - Myelitis - Encephalomyelitis (Acute disseminated) - Tropical spastic paraparesis
Systemic atrophies primarily affecting the CNS	Huntington's Spinocerebellar ataxia (Friedreich's ataxia, Ataxia telangiectasia, Hereditary spastic paraplegia) Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio Londe - MND (ALS, PMA, PBP, PP, PLS)
Extrapyramidal and movement disorders	Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration Dystonia/Dyskinesia (Spasmodic torticollis, Meige's, Blepharospasm) Essential tremor - Myoclonus - Lafora Chorea (Choreoathetosis) - Restless legs - Stiff person
Other degenerative / demyelinating diseases	Alzheimer's - Pick's - Alpers' - Dementia with Lewy bodies - Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis
Seizure/epilepsy	Focal (Simple partial, Complex partial) - Generalised (Tonic-clonic, Absence, Atonic, Benign familial neonatal) Lennox-Gastaut - West - Epilepsia partialis continua - Status epilepticus (Complex partial status epilepticus)
Headache	Migraine (Familial hemiplegic) - Cluster - Vascular - Tension
Vascular	Transient ischemic attack (Amaurosis fugax, Transient global amnesia) Cerebrovascular disease (MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke)
Sleep disorders	Insomnia - Hypersomnia - Sleep apnea (Ondine's curse) - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase
Other	Intracranial hypertension: Hydrocephalus (Normal pressure) - Idiopathic intracranial hypertension Encephalopathy - Brain herniation - Cerebral edema - Reye's - Syringomyelia - Syringobulbia - Spinal cord compression

v • d • e WikiDoc Research Resources for Cerebral edema
Articles on Cerebral edema	Most recent articles on Cerebral edema • Most cited articles on Cerebral edema • Review articles on Cerebral edema • Articles on Cerebral edema in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Cerebral edema	Powerpoint slides on Cerebral edema • Images of Cerebral edema • Photos of Cerebral edema • Podcasts & MP3s on Cerebral edema • Videos on Cerebral edema
Evidence Based Medicine Regarding Cerebral edema	Cochrane Collaboration on Cerebral edema • Bandolier on Cerebral edema • TRIP on Cerebral edema
Cost Effectiveness of Cerebral edema	Cost Effectiveness of Cerebral edema
Clinical Trials Involving Cerebral edema	Ongoing Trials on Cerebral edema at Clinical Trials.gov • Trial results on Cerebral edema • Clinical Trials on Cerebral edema at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Cerebral edema	US National Guidelines Clearinghouse on Cerebral edema • NICE Guidance on Cerebral edema • NHS PRODIGY Guidance • FDA on Cerebral edema • CDC on Cerebral edema
Textbook Information on Cerebral edema	Books and Textbook Information on Cerebral edema
Pharmacology Resources on Cerebral edema	Dosing of Cerebral edema • Drug interactions with Cerebral edema • Side effects of Cerebral edema • Allergic reactions to Cerebral edema • Overdose information on Cerebral edema • Carcinogenicity information on Cerebral edema • Cerebral edema in pregnancy • Pharmacokinetics of Cerebral edema •
Genetics, Pharmacogenomics, and Proteinomics of Cerebral edema	Genetics of Cerebral edema • Pharmacogenomics of Cerebral edema • Proteomics of Cerebral edema
Newstories on Cerebral edema	Cerebral edema in the news • Be alerted to news on Cerebral edema • News trends on Cerebral edema
Commentary on Cerebral edema	Blogs on Cerebral edema
Patient Resources on Cerebral edema	Patient resources on Cerebral edema • Discussion groups on Cerebral edema • Patient Handouts on Cerebral edema • Directions to Hospitals Treating Cerebral edema • Risk calculators and risk factors for Cerebral edema
Healthcare Provider Resources on Cerebral edema	Symptoms of Cerebral edema • Causes & Risk Factors for Cerebral edema • Diagnostic studies for Cerebral edema • Treatment of Cerebral edema
Continuing Medical Education (CME) Programs on Cerebral edema	CME Programs on Cerebral edema
International Resources on Cerebral edema	Cerebral edema en Espanol • Cerebral edema en Francais
Business Resources on Cerebral edema	Cerebral edema in the Marketplace • Patents on Cerebral edema
Informatics Resources on Cerebral edema	List of terms related to Cerebral edema