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Potentially life-threatening emergency
Cerebral edema
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Potentially life-threatening emergency

Cerebral edema

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Contributors: Andrea Wasilewski MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Cerebral edema is swelling of the brain parenchyma due to excessive fluid accumulation. It may be focal or generalized. Cerebral edema is defined as either vasogenic, cytotoxic, or transependymal. Vasogenic edema occurs when the blood-brain barrier is disrupted and is most often seen with focal lesions such as brain tumors and abscesses. Cytotoxic edema occurs when the blood-brain barrier is intact with impaired cellular metabolism and is most commonly seen with ischemic stroke, toxic exposure, metabolic derangements, and hypoxia. Transependymal edema occurs due to obstructive hydrocephalus and breakdown of the cerebrospinal fluid (CSF)-brain barrier.

Cerebral edema is characterized by blurred vision, intracranial hypertension, headache, and loss of consciousness. Other common signs and symptoms are nausea, vomiting, sudden elevated blood pressure, mental status alteration, and decreased heart rate. It presents a life-threatening medical emergency leading to herniation, coma, and brain death.

Causes include severe brain trauma, ischemic stroke, meningitis, encephalitis, hepatic encephalopathy, brain cancer, diabetic ketoacidosis, eclampsia, or cerebral infarction. It also occurs as a form of high-altitude edema. Cerebral edema may occur in infants and adults.

Management aims to reduce intracranial pressure and excess brain fluid and includes corticosteroids, osmotic agents, diuretics, inotropics and other pharmacotherapy, decompression, and surgery.

Codes

ICD10CM:
G93.6 – Cerebral edema

SNOMEDCT:
2032001 – Cerebral Edema

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Diffuse cerebral edema:
Focal cerebral edema:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 04/06/2018
Last Updated: 04/06/2018
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Potentially life-threatening emergency
Cerebral edema
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Cerebral edema : Blurred vision, Headache, Nausea, Vomiting, Delirium, Loss of consciousness, Mental status alteration, HR decreased
Imaging Studies image of Cerebral edema
Axial CT image demonstrates diffuse loss of the gray-white matter interface and sulcal prominence. Findings were consistent with post-traumatic diffuse cerebral edema.
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