Swelling of the brain - emergency measures and proper treatment

The cells and the intervening space of the central regulating organ of the central nervous system can accumulate liquid. This leads to swelling or swelling of the brain, which provokes an increase in its volume and an increase in intracranial pressure . This condition is considered an extremely dangerous pathology requiring immediate treatment.

Edema of the brain - types

The classification of the considered disease is based on the mechanisms of its origin and subsequent flow. There is a cerebral edema of these types:

Additionally, cerebral edema can differentiate depending on the causes of its formation:

Vasogenic cerebral edema

Between the circulatory and central nervous system there is a physiological obstacle - the blood-brain barrier (BBB). With its help, the water content in the intercellular space is regulated. As the permeability of the BBB increases, vasogenic brain edema appears. It occurs against the background of the following violations:

Cytotoxic edema of the brain

Cells susceptible to a poisonous effect (external or internal), start to function incorrectly. Their metabolism and permeability of membranes are changing. Tissue accumulates fluid and develops cytotoxic edema or swelling. This form of pathology is often diagnosed after strokes and severe intoxication, but it is reversible within the first 6-8 hours.

Interstitial cerebral edema

In the main organ of the central nervous system, the cerebrospinal fluid or cerebrospinal fluid circulates constantly, mainly in the ventricles. When the pressure in them sharply and strongly rises, there is an interstitial edema of the brain. The condition described provokes impregnation of tissues with excess liquor. As a result, the cells increase in volume and swell.

Osmotic cerebral edema

Any liquid contains particles dissolved in it. Their quantity in 1 kg of moisture is called osmolarity. Normally, this indicator for plasma and the governing body of the nervous system is almost identical. If hyperosmolarity (too high) of "gray matter" is observed, a diagnosis of brain edema is established. Because of the increase in the volume of particles in the cerebrospinal fluid, the tissues tend to reduce their concentration, and absorb the liquid from the plasma. Such a brain swelling is recorded with metabolic type encephalopathies. It often causes hyperglycemia, renal and hepatic insufficiency.

Cerebral edema - causes

The most common factors provoking the complication in question are:

There are less common reasons that explain what causes brain swelling:

Edema of the brain after a stroke

Disturbance of blood circulation in the central organ of the central nervous system begins with clotting of the vessel with a thrombus. Gradually, the tissues receive less oxygen, which is why their oxygen starvation develops. Cells die and actively absorb any moisture, there is ischemic edema of the brain. In some cases, the biological fluid that accumulates in front of the thrombus can break the vessel walls. This phenomenon increases the cerebral edema in stroke, because the tissues after the hemorrhage absorb even more moisture. This variant of cell swelling is considered the most dangerous.

Edema of the brain after surgery

Pathology almost always accompanies surgical interventions in the area of ​​the skull. In rare cases and against the background of other procedures, there is cerebral edema - an operation performed using epidural anesthesia, or excessive administration of hypotonic and saline solutions intravenously. Sometimes swelling of the cells occurs due to complications of surgical intervention:

Alcoholic edema of the brain

Excessive amounts of ethyl alcohol in the body lead to severe poisoning. Alcoholics are very often diagnosed with cerebral edema - the reasons are a long intoxication of cells, because of what irreversibly their metabolism and functioning. Damaged tissues absorb moisture, provoking swelling and expansion. Such a brain swelling is also characteristic of poisoning with other substances:

Edema of the brain for allergies

Inadequate response of the immune system to stimuli in some people is accompanied by anaphylactic shock. In such cases, the factor that provokes brain edema is an allergy. Against the backdrop of hypersensitivity, the intensity of blood flow in the entire body decreases drastically, blood pressure is significantly reduced and collapse develops. Because of the lack of sufficient blood supply to vital structures, gray matter cells absorb liquid and swell.

Swelling of the brain - symptoms

The clinical picture of the described pathology is always identical and does not depend on its causes or on the mechanisms of development. There are 3 groups of signs that characterize the brain edema - the symptoms are divided into the following types:

  1. Syndrome of intracranial hypertension. Due to the swelling of the tissues, their volume considerably increases. Excess fluid in the skull leads to a strong increase in pressure. This provokes a nausea, a violent and unbearable headache, indomitable vomiting. If the swelling of the brain continues for a long time, there is a worsening of consciousness.
  2. Focal clinical manifestations. Swelling of tissues in certain parts of the central nervous system's control organ causes a violation of their specific functions. As a result, paralysis, visual, speech disorders, impaired coordination of movements are noted. Sometimes the patient is completely incapable of performing higher nervous activity and is in an unconscious state.
  3. Stem signs. Swelling-swelling of the brain can lead to the displacement of some structures of the organ, squeezing increased volumes of tissues of nearby nerve endings and blood vessels. Against the backdrop of such phenomena there is a violation of cardiac and respiratory activity, worsening of blood circulation, oppression of pupillary reaction and other life-threatening pathologies.

Cerebral edema - treatment

Poorly expressed degree of the disease, for example, after a concussion or a minor injury, does not need special therapy. Such variants of swelling of tissues pass independently for 2-4 days. Hospitalization is necessary if the cerebral edema progresses - the treatment of complex and dangerous types of pathology is carried out only in the intensive care unit.

The main goal of therapy is the normalization of cerebral perfusion pressure (CPD). It is responsible for the blood supply, the supply of oxygen and nutrients to the neurons. The CPR is the difference between the mean arterial and the sum of intracranial and central venous pressure. Other treatment tasks:

Edema of the brain - emergency aid

Patients with this severe diagnosis should be immediately hospitalized.

First pre-medical care:

  1. Having discovered signs of cerebral edema, immediately call a team of doctors.
  2. Put the victim on a horizontal surface.
  3. Provide fresh air.
  4. If there is vomiting, turn the person's head to the side.
  5. Unfasten or remove the squeezing clothes.
  6. In case of seizures, carefully hold the head and limbs of the patient, preventing the application of bruises and injuries.

Edema of the brain - drugs

Dehydration therapy is used to remove excess fluid from cells and cerebral tissues. If severe cerebral edema is found in adults, intravenous administration of osmotic diuretics is first prescribed with the help of a dropper - Mannitol, Albumin and analogues. After relief of the acute condition of the patient is transferred to loop diuretics:

When intracranial pressure is too high and it is not possible to eliminate cerebral edema with the listed drugs, ventriculostomy is recommended. This is a surgical intervention that allows you to remove excess fluid from the tissues. The procedure is the introduction of a cannula (hollow thick needle) into one of the ventricles of the brain in order to create drainage. Such manipulation provides instant normalization of pressure and outflow of excess liquid.

On the background of cerebral swelling, hypoxia often occurs. Oxygen therapy is used to stop oxygen starvation and restore respiratory activity. The simplest variant is the use of a special mask with a supply of concentrated gas. In modern clinics oxigenobarotherapy is performed - placing the patient in a special air environment with increased oxygen pressure. In severe cases, artificial ventilation is performed urgently.

To improve cerebral metabolism and normalize the functions of brain cells, local cooling of the head and the administration of drug solutions that activate metabolic processes are used:

Swelling-swelling of the brain is accompanied by permeability of the cell membranes and weakening of the vascular walls. Cope with these disorders help glucocorticosteroid hormones:

To stabilize blood pressure are appointed:

Many patients require the management of psychomotor agitation. For this purpose, the following apply:

Restoration of the central nervous system is provided by angioprotectors, hemostatics, antiginoxants, proteolytic enzyme inhibitors and other medication groups, which include the following:

Sometimes it is necessary to use antibiotics, mainly cephalosporins with a wide spectrum of action:

Cerebral edema - consequences

In rare cases, doctors manage to completely eliminate swelling of tissues. The brain edema is more often complicated - consequences:

Edema of the brain - a prognosis for life

The examined pathology progresses very quickly, it is possible to stop it without complications only with toxic swelling of tissues in young and healthy people. In other cases, there are consequences after cerebral edema of varying severity. The prognosis depends on the extent of the organ damage, the affected departments and the severity of the concomitant disorders. In most situations, swelling of the brain provokes irreversible complications, sometimes swelling leads to the death of a person.