Cerebral Edema: Causes, Symptoms, Treatment, Prognosis

Cerebral Edema is an extremely serious pathological condition in which there is swelling of the brain which leads to increased pressure within the brain. This swelling of the brain may occur due to a variety of reasons like an automobile crash with a traumatic brain injury, infections spreading to the brain, or any other illness or injury. Cerebral Edema is one of the most difficult conditions to treat and is often at times fatal. The brain is the central processing unit of the body which plays a critical role in controlling all the bodily functions.

The skull which protects the brain from any injury leaves very little room for the brain itself and therefore Cerebral Edema causes immense pressure on the brain area and this is the reason why this condition is extremely serious. Cerebral Edema is also known by various names like brain swelling, brain edema, and elevated intracranial pressure.

Cerebral Edema can occur either throughout the brain or is confined to certain locations of the brain depending on the injury. Irrespective of where the swelling occurs, it results in immense pressure within the skull. The pressure that the brain exerts on the skull is called the intracranial pressure and in cases of Cerebral Edema this intracranial pressure significantly increases.

Due to this increased pressure, the blood supply to the brain gets cut down significantly and thus the oxygen which is required by the brain to function is depleted. When there is depletion of oxygen levels in the brain it causes the cells to degenerate rapidly and die resulting in permanent brain damage and in some cases end of life due to Cerebral Edema.

As stated Cerebral Edema can be caused due to a serious automobile crash causing serious head injury which is also known by the name of traumatic brain injury. It can also be caused due to other illnesses and infections like a brain tumor. Below mentioned are some of the causes of Cerebral Edema:

Traumatic Brain Injury or TBI: This usually occurs after a sudden trauma to the head which is severe enough to affect the brain. This trauma can be as a result of a hard object hitting the head with significant force, a motor vehicle or a motorcycle crash, fall from a significant height directly on the head. These forms of trauma or injury can cause the brain to swell up and result in Cerebral Edema.

Ischemic Strokes: This is perhaps the most common type of stroke which causes Cerebral Edema. In ischemic strokes there are clots formed near the brain which does not allow adequate blood flow to the brain causing depleted oxygen levels in the brain resulting in Cerebral Edema.

Brain Hemorrhage: Hemorrhagic stroke or brain hemorrhage refers to a condition in which the blood vessel within the brain starts to leak blood. Due to this leakage of blood, the pressure within the brain increases causing Cerebral Edema. Chronic uncontrolled hypertension is the most common cause of brain hemorrhage resulting in Cerebral Edema.

Meningitis: Certain infections of the brain may also cause Cerebral Edema and one of these infections is meningitis. In this infection, the covering of the brain gets inflamed. This is usually caused by bacteria, viruses, or in some cases some medications may also cause meningitis which may result in Cerebral Edema.

Encephalitis: This is yet another infection which may result in Cerebral Edema. This is an infection in which the brain itself gets inflamed usually by some sort of virus that infiltrates the brain. These viruses are spread by certain insect bites causing Cerebral Edema.

Toxoplasmosis: This is a parasitic infection which causes Cerebral Edema. This is usually seen in infants and people with compromised immune systems.

Tumors: Tumors may be perhaps the most common cause apart from a traumatic brain injury to cause Cerebral Edema. If the tumor is malignant it starts to grow and spread pretty rapidly putting increased pressure on the brain resulting in Cerebral Edema.

The symptoms of Cerebral Edema or swelling of the brain are quite variable and depend on the location of the swelling and the severity of the injury or infection. Some of the symptoms of Cerebral Edema are:

• Frequent severe headaches
• Neck Pain
• Persistent nausea with or without vomiting
• Persistent dizziness
• Breathing irregularities
• Vision disturbances
• Loss of recent or remote memory
• Ambulation difficulties
• Problems with speaking
• Seizures
• Unconsciousness.

How is Cerebral Edema Diagnosed?

Depending on the nature of symptoms and the history of injury of infection, Cerebral Edema can be diagnosed. Some of the investigations done to confirm the diagnosis of Cerebral Edema are:

• A comprehensive head and neck examination to see if there are any abnormalities
• A comprehensive neurological examination with a test of memory to see whether there are any signs of memory loss and whether all the neurological functions are appropriate
• Once Cerebral Edema is suspected, then advanced imaging studies in the form of an MRI or a CT scan of the brain is done to see the location and severity of the swelling
• Blood tests will be done to identify other causes of Cerebral Edema like an infection

All these above tests will confirm the diagnosis of Cerebral Edema.

For minor cases of Cerebral Edema, which may be caused by a minor concussion tends to resolve without any sort of intervention and the patient may be back to normal within a few days but in majority of cases of Cerebral Edema, treatment needs to be started emergently as it is quite a serious condition and can be life threatening.

The aim of the treatment for cerebral edema is to decrease the swelling around the brain and reduce the pressure being put on the brain and ensure proper blood supply reaches the brain so that the cells do not start dying due to oxygen depletion. This often requires both medical and surgical approaches. If immediate treatment is given for Cerebral Edema then the recovery is quick and the patient can become as close to normal, although some damage to the brain may still remain due to Cerebral Edema.

Some of the treatments for Cerebral Edema are:

Oxygen Therapy: The oxygen will be supplied through an artificial respiratory system so that the blood oxygen levels do not get diminished and the brain still receives sufficient oxygen to protect the cells from dying and thus preventing serious complications.

IV Fluids: The patient will be administered intravenous fluids along with medications to prevent the blood pressure from dropping too low and ensuring the brain is getting appropriate supply of blood and oxygen. In some cases, IV fluids may make Cerebral Edema worse and hence it is vital to choose the right fluids in fixed amounts to prevent such situations from arising due to Cerebral Edema.

Hypothermia: This is another form of treatment for Cerebral Edema but is very rarely used due to the difficulty in doing this therapy correctly. In this form of treatment the temperature of the body is lowered to allow the brain to heal faster and also relieve Cerebral Edema.

Medication: Medications are basically given to reduce welling or dissolve any clots which may have resulted in Cerebral Edema and allow proper flow of blood to the brain. The drug of choice depends on the symptoms the patient is experiencing and the cause of Cerebral Edema.

Ventriculostomy: This is an interventional procedure done to relieve the pressure from the brain. In this procedure, a thin tube is inserted within the brain and CSF or cerebrospinal fluid is drained from the brain to decrease the pressure being out on the brain due to Cerebral Edema

Surgery: This is quite a vital aspect for treatment of Cerebral Edema. In this procedure a segment of the skull may be removed to relieve pressure from the brain. Another reason for a surgical procedure is to remove or repair the cause of the swelling which may be a clot, tumor, or repairing an artery or vessel which may be hemorrhaging causing Cerebral Edema.

The prognosis for Cerebral Edema depends on the severity of the swelling and the location of it along with how soon the patient gets treatments for it. Prognosis for minor cases of Cerebral Edema due to concussion is quite good but for severe cases of cerebral edema, if emergent treatment is not given then the prognosis deteriorates quite rapidly and may result in life threatening complications due to Cerebral Edema.

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