Edema in the brain is a life-threatening condition. So what are the symptoms of cerebral edema? When to go to the doctor? Professor Doctor Engin Çakar answers your questions.
What is Brain Edema?
Cerebral edema is a potentially life-threatening condition characterized by fluid accumulation in the brain. Since the brain is in a closed environment within the skull, the formation of edema increases the intracranial pressure. Increased intracranial pressure reduces blood flow to the brain. As a result, the brain may not receive enough oxygen and brain damage may develop. Brain damage leads to cell death, further increasing edema. In the case of severe edema, fluid outflow from the brain is also difficult and the clinical situation may worsen rapidly.
Edema is the body’s natural response to any damage or injury. For example, when our foot is sprained, it swells. The permeability of blood vessels increases. Immune system cells, which will fight the microbes entering the body and clean the damaged tissue, pass through the vein to the tissue. Treatment of edema in similar injuries is rest, cold application, keeping the affected limb above the heart level and wrapping with a compression bandage. Cerebral edema is dangerous and difficult to treat because there is no room for the brain to expand . If cerebral edema is severe, it can cause permanent damage to the person and even death.
What are the Symptoms of Brain Edema?
Brain edema may occur due to head injury, tumor, vascular occlusion or infection. Symptoms vary according to the cause and severity. Firstly
- coordination disorder
- numbness in the body
may give such indications. If brain edema becomes severe, symptoms such as changes in consciousness, mood changes, speech difficulties, urinary incontinence, seizures, muscle weakness may be added.
What Causes Edema in the Brain?
1. Traumatic Brain Injury
Direct blows to the head due to traffic accidents, falls, sports injuries, and violent events can cause edema in the brain. In severe head injury, skull fracture, direct or acceleration-induced damage to the brain tissue, cracking of cerebral vessels and cerebral hemorrhage may occur. All these damages also lead to payment.
2. Cerebrovascular Occlusion (Stroke)
In case of occlusion of brain vessels, nerve cells cannot reach the oxygen they need. Nerve cell death can cause edema in the brain.
Infections that affect brain tissue and meninges, such as encephalitis and meningitis, can lead to brain edema with immune system activation. In utero and newborn babies, parasitic toxoplasma infection can lead to brain edema. Sinus infection and meningitis disease can lead to abscess formation in the brain. Brain abscess can cause edema with both inflammatory reaction and mass effect.
4. Brain Tumors
Brain tumors put pressure on the tissue around them. Cell death and edema occur in the tissue that does not bleed well due to the increase in pressure. The tumor may make fluid outflow from the brain difficult; it can also increase edema by causing the formation of new vessels.
5. Other reasons
Rapid ascent to high altitude (usually above 4000 meters) (acute mountain sickness), drug abuse, carbon monoxide poisoning and other poisonings can also cause cerebral edema.
Brain Edema Diagnosis
Diagnosing cerebral edema is not always easy. First of all, the complaints are started and a comprehensive neurological examination is performed. Examination of the cranial nerves, examination of the base of the eye, examination of sensation, strength and reflexes in the arms and legs, and evaluation of consciousness are the most basic examination steps. Brain edema is not a disease per se, it is the result of another problem. Brain tomography and magnetic resonance imaging may be required to identify the underlying disease. Blood tests are useful for evaluating infection parameters.
How Is Brain Edema Treated?
Brain edema caused by mild head trauma (concussion) can go away on its own with rest. However, in most cases, cerebral edema is a life-threatening problem and its treatment is urgent. Treatments aimed at reducing edema and ensuring adequate blood circulation are applied. For its final treatment, underlying causes such as infection and tumor should be eliminated.
Some drugs can be used to reduce cerebral edema. These include diuretic (diuretic) drugs and cortisone therapy. If the cause of edema is vascular occlusion, clot-dissolving drugs can be used.
High-density (high water-holding capacity) serum (for example, mannitol) can be given intravenously to remove the extra water accumulated in the brain.
Oxygen Therapy (Hyperventilation)
Controlled over-breathing (hyperventilation) can reduce intracranial pressure. Oxygen therapy may be provided by mechanical breathing apparatus or otherwise. Oxygen therapy (hyperventilation) reduces the amount of carbon dioxide in the blood. The decrease in carbon dioxide in the blood can reduce intracranial pressure and edema by decreasing cerebral blood circulation.
Hypothermia, which means controlled cooling of the head and body, slows down the metabolism of the brain and reduces edema. Controlled application is difficult, it can be done in certain centers.
In order to reduce intracranial pressure, a small hole can be made in the skull and a tube can be inserted into the cavities called the ventricles where the cerebrospinal fluid is located; Intracranial pressure can be reduced by allowing cerebrospinal fluid to flow out of the brain.
A part of the skull can be removed (craniotomy) to provide space for the brain to expand. If the tumor is the source of the edema, it can be surgically removed. In case of cerebral hemorrhage caused by aneurysm, vascular repair can be performed.
Long-Term Consequences of Brain Edema
Edema and associated disease can cause permanent brain damage. Problems such as sleepiness, cognitive problems, headache, depression, difficulty in communication, and mobility may occur. In long-term treatment , recovery can be achieved with appropriate physical therapy and rehabilitation determined according to the needs of the person .