cerebral oedema

脳浮腫

関

brain edema、cerebral edema

WordNet

1. of or relating to the cerebrum or brain; "cerebral hemisphere"; "cerebral activity"
2. involving intelligence rather than emotions or instinct; "a cerebral approach to the problem"; "cerebral drama" (同)intellectual

PrepTutorEJDIC

1. 大脳の,脳の / 頭脳的な,知的な

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/07/17 19:57:36」(JST)

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Cerebral edema
Classification and external resources
Edema (darker areas) surrounding a secondary brain tumor.
ICD-10	G93.6
ICD-9	348.5
DiseasesDB	2227
MeSH	D001929

Cerebral edema or cerebral œdema is an excess accumulation of water in the intracellular or extracellular spaces of the brain.

Types

Four types of cerebral edema have been distinguished:

Vasogenic

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 the 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). Some of the special subcategories of vasogenic edema include:

Hydrostatic cerebral 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 (extracellular fluid) from the capillaries.

Cerebral edema from brain cancer

Cancerous glial cells (glioma) of the brain can increase secretion of vascular endothelial growth factor (VEGF) which weakens the junctions of the blood–brain barrier. Dexamethasone can be of benefit in reducing VEGF secretion.

High altitude cerebral edema

High altitude cerebral edema (or HACE) is a severe form of (sometimes fatal) altitude sickness. HACE is the result of swelling of brain tissue from leakage of fluids from the capillaries due to the effects of hypoxia on the mitochondria-rich endothelial cells of the blood–brain barrier.

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.

Cytotoxic

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. Cytotoxic 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

Normally cerebral-spinal fluid (CSF) and extracellular fluid (ECF) osmolality of the brain is slightly lower 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.

Interstitial

Occurs in obstructive hydrocephalus. This form of edema is due to rupture of the CSF-brain barrier resulting in trans-ependymal flow of CSF which causes CSF to penetrate the brain and spread to the extracellular spaces and the white matter. This is differentiated from vasogenic edema in that interstitial cerebral edema CSF contains almost no protein.

Treatment

Treatment approaches can include osmotherapy using mannitol, diuretics and surgical decompression.

References

External links

• MedPix Vasogenic Edema

UpToDate Contents

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• 1. 成人における頭蓋内圧亢進の評価およびマネージメント evaluation and management of elevated intracranial pressure in adults
• 2. 原発性および転移性脳腫瘍患者における血管原性浮腫のマネージメント management of vasogenic edema in patients with primary and metastatic brain tumors
• 3. 糖尿病性ケトアシドーシスの小児における脳浮腫 cerebral edema in children with diabetic ketoacidosis
• 4. 急性高山病および高地脳浮腫 acute mountain sickness and high altitude cerebral edema
• 5. 小児における頭蓋内圧亢進（ICP） elevated intracranial pressure icp in children

English Journal

• Effects of Ecballium elaterium on brain in a rat model of sepsis-associated encephalopathy.

• Arslan D1, Ekinci A2, Arici A3, Bozdemir E4, Akil E1, Ozdemir HH1.
• The Libyan journal of medicine.Libyan J Med.2017 Dec;12(1):1369834. doi: 10.1080/19932820.2017.1369834.
• PMID 28859554

• Crotalus helleri venom preconditioning reduces postoperative cerebral edema and improves neurological outcomes after surgical brain injury.

• Kim CH1, McBride DW1, Sherchan P1, Person CE2, Gren ECK2, Kelln W2, Lekic T3, Hayes WK2, Tang J1, Zhang JH4.
• Neurobiology of disease.Neurobiol Dis.2017 Nov;107:66-72. doi: 10.1016/j.nbd.2017.03.001. Epub 2017 Mar 9.
• PMID 28286182

• Methylene blue attenuates neuroinflammation after subarachnoid hemorrhage in rats through the Akt/GSK-3β/MEF2D signaling pathway.

• Xu H1, Li J1, Wang Z1, Feng M2, Shen Y3, Cao S1, Li T1, Peng Y1, Fan L1, Chen J1, Gu C1, Yan F1, Wang L1, Chen G4.
• Brain, behavior, and immunity.Brain Behav Immun.2017 Oct;65:125-139. doi: 10.1016/j.bbi.2017.04.020. Epub 2017 Apr 27.
• PMID 28457811

Japanese Journal

• Sphingomonas Paucimobilis: An Unusual Cause of Meningitis—Case Report

• Neurologia medico-chirurgica 54(4), 337-340, 2014
• NAID 130003383240

• Cerebral oedema as a possible complication of treatment with imatinib

• Lancet 359, 1751-1752, 2002
• NAID 30005709076

• Cerebral hyperemia and nitric oxide synthase in rats with ammonia-induced brain oedema

• J. Hepatol. 34, 548-554, 2001
• NAID 30007963914

Related Links

• Cerebral Oedema | Just another Meacos site

Cerebral oedema is an excess accumulation of water in the intracellular or extracellular spaces of the brain. Four types of cerebral edema have been distinguished: Vasogenic Cerebral Oedema Cytotoxic Cerebral Oedema Osmotic ...

• Types | Cerebral Oedema

Occurs in obstructive hydrocephalus. This form of oedema is due to rupture of the CSF-brain barrier resulting in trans-ependymal flow of CSF which causes CSF to penetrate the brain and spread to the extracellular spaces and the ...

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関連記事	「cerebral」「oedema」

「cerebral」

　　[★]

• adj.

• 大脳の、大脳性の、脳性の、脳の

関

brain、cerebri、cerebro、cerebrum、encephalic、encephalo、encephalon

　 　 　

「oedema」

　　[★]

浮腫

関

dropsy、edema、edematous