Abstract
Elevation of intracranial pressure in the clinical and experimental setting can be induced by a variety of brain insults. Cerebrovascular engorgement (swelling), may occur as a loss of autoregulation which would elevate intracranial pressure because of an increased blood volume. An increase of ICP may also result from disturbances at the capillary level by extravasation of serum fluid into the interstitium. Formation of vasogenic brain edema may continue as long as the propelling forces of the arterial pressure maintains an effective transmural pressure gradient (13,14). The area of increased permeability (13,14) and the duration of the opening of the blood-brain barrier (4,14) are additional variables. The increased interstitial fluid could lead to an increased brain volume and, hence, a further rise in intracranial pressure. Brain insults can affect glial and neuronal metabolism so that the cellular function is significantly altered. Examples comprise the processes that occur with ischemia and hypoxia. Blockade of cellular energy metabolism may lead to membrane permeability changes and alterations of the sodium pump. Cellular (cytotoxic) edema and swelling may follow (13). An increased water content in the intracellular compartment of the brain may also lead to an overall increase in brain volume and, hence, of the intracranial pressure.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Baethmann A, Oettinger W, Rothenfußer W, Geiger R, Pathophysiology of cerebral edema, in: “Pathophysiology of cerebral energy metabolism”, Mrsulja BB, Rakic LM, Klatzo I, Spatz M, eds., Plenum Publ. Corp. (1979).
Baethmann A, Van Harreveld A, Water and electrolyte distribution in gray matter rendered edematous with a metabolic inhibitor, J Neuropathol Exp Neurol 32: 408 (1973).
Bruce DA, Ter Weeme C, Kaiser G, Langfitt TW, The dynamics of small and large molecules in the extracellular space and cerebro-spinal fluid following cold injury of the cortex, in: “Dynamics of Brain Edema”, eds., Pappius H, Feindel W, Springer-Verlag, Heidelberg (1976).
Clasen RA, Cooke PM, Pandolfi S, Boyd D, Raimondi AJ, Experimental cerebral edema produced by focal freezing: I. An anatomic study utilizing vital dye techniques, J Neuropathol Exp Neurol 21: 579 (1962).
Clasen RA, Pandolfi S, Casey D,Jr, Furosemide and pentobarbital in cryogenic cerebral injury and edema, Neurology (Minneap.), 24: 642 (1974).
Frei HJ, Wallenfang T, Pöll W, Schubert M, Brock M, Regional cerebral blood flow and regional metabolism in cold injury induced brain edema, Acta Neurochir 29: 15 (1973).
Go KG, Zijlstra WG, Flanderjin A, Zuiderveen F, Circulatory factors influencing exudation in cold-induced cerebral edema, Exp Neurol 42: 332 (1974).
Harbaugh RD, James HE, Marshall LF, Shapiro HM, Laurin R, Acute therapeutic modalities for experimental vasogenic edema, Neurosurgery 5: 656 (1979).
Herrmann HD, Neuenfeldt D, Development and regression of disturbances of the blood-brain barrier and edema in tissue surrounding a circumscribed cold lesion, Exp Neurol 34: 115 (1972).
Hadjidimos A, Fischer F, Reulen HJ, Restitution of vasomotor autoregulation by hypocapnia in brain tumors, in: “Advances in Neurosurgery, Vol III”, Penzholz H, Brock M, Hamer J, Klinger M, Spoerri O, eds., Berlin, Heidelberg, New York (1975).
James HE, Bruce DA, Welsh F, Cytotoxic edema produced by 6-aminonicotinamide and its response to therapy, Neurosurgery, 3: 196 (1978).
James HE, Laurin R, Intracranial hypertension and brain edema in albino rabbits: Part I: Experimental models, Acta Neurochir (Wien) 55: 213 (1981).
Klatzo I, Neuropathological aspects of brain edema, J Neuropathol Exp Neurol 26: 1 (1967).
Klatzo I, Wisniewski H, Steinwall O, Streicher E, Dynamics of cold injury edema, in: “Brain edema”, eds., Klatzo I, Seitelberger F, Springer-Verlag, New York (1967).
Lassen NA, The luxury perfusion syndrome and its possible relation to acute metabolic acidosis localized within the brain, Lancet 2: 113 (1966).
Matsumoto A, Kogure K, Utsunomiya Y, Busto R, Scheinberg P, Reinmuth OM, Energy metabolism and CBF in cold-induced brain edema: Comparison of the effect of dexamethasone under nitrous oxide and pentobarbital anesthesia, in: “Blood flow and metabolism in the brain”, eds., Harper AM, Jennett WB, Miller JD, Rowan JO, Edinburgh, Churchill-Livingstone (1975).
Millson CH, James HE, Shapiro HM, Laurin R, Intracranial hypertension and brain edema in albino rabbits. Part 2: Effect of acute therapy with diuretics, Acta Neurochir 56: 167 (1981).
Millson CH, James HE, Shapiro HM, Laurin R, Intracranial hypertension and brain edema in albino rabbits. Part 3: Effect of acute simultaneous diuretic and barbiturate therapy, Acta Neurochir 61: 271 (1982).
Pappius HM, Effects of steroids on cold injury edema, in: “Steroids and brain edema”, eds., Reulen HJ, Schürmann K, Springer-Verlag, New York (1972).
Pappius HM, Dayes LA, Hypertonic urea: Its effect on the distribution of water and electrolytes in normal and edematous brain tissue, Arch Neurol 13: 395 (1965).
Pollay M, Formation of cerebrospinal fluid: Relations or studies of isolated choroid plexus to the standing gradient hypothesis, J Neurosurg 42: 665 (1975).
Reed DJ, The effects of furosemide on cerebrospinal fluid flow in rabbits, Arch Int Pharmacodyn Ther 178: 324 (1969).
Reulen HJ, Vasogenic brain edema: New aspects in its formation, resolution and therapy. Br J Anesth 48: 741 (1976).
Reulen HJ, Graham R, Spatz M, Klatzo I, Role of pressure gradients and bulk flow in dynamics of vasogenic brain edema, J Neurosurg 46: 24 (1977).
Reulen HJ, Kreysch HG, Measurements of brain tissue pressure in cold induced cerebral edema, Acta Neurochir (Wien) 29: 29 (1973).
Smith AL, Marque JJ, Anesthestics and cerebral edema, Anesthesiology 45: 64 (1976).
Tutt HP, Pappius HM, Studies on the mechanisms of action of steroids in traumatized brain, in: “Steroids and brain edema”, eds., Reulen HJ, Schürmann K, Springer-Verlag, New York (1972).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1986 Plenum Press, New York
About this chapter
Cite this chapter
James, H.E., Werner, R., del Bigio, M. (1986). Changes in Brain Edema Movement Following Experimental Brain Insults and Acute Therapy. In: Baethmann, A., Go, K.G., Unterberg, A. (eds) Mechanisms of Secondary Brain Damage. NATO ASI Series, vol 115. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-5203-7_13
Download citation
DOI: https://doi.org/10.1007/978-1-4684-5203-7_13
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-5205-1
Online ISBN: 978-1-4684-5203-7
eBook Packages: Springer Book Archive