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Management of Brain Edema in Head Injury

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Advances in Brain Resuscitation

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Abstract

Strictly speaking, brain edema represents an increase in the bulk of the brain that has been produced by an increase in its tissue water content. In the context of the management of severely head-injured patients in the intensive care unit, however, the term brain edema is commonly used in a wider context, to include all conditions of increased brain volume or brain swelling frequently, but not always, associated with raised intracranial pressure (ICP). There are many potential causes of raised ICP after head injury. These include formation of true brain edema, development of an intracranial mass lesion (such as a subdural hematoma, which may also be associated with edema formation), acute swelling of the brain due to an increase in cerebral blood volume, and accumulation of cerebrospinal fluid in the form of acute hydrocephalus. For optimal management of the severely head-injured patient and effective treatment of raised ICP and its adverse sequelae, it is important to be aware of the several possible causes of intracranial hypertension and different mechanisms by which water content may increase and ICP rise. Wherever possible, therapy should be chosen that is appropriate to the underlying pathophysiological mechanism. In the comatose head-injury patient, the therapeutic “window” is narrow and time does not permit a random sequence of empirically applied therapies for reduction of ICP and resolution of brain edema.

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Author information

Authors and Affiliations

  1. Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, Scotland, UK

    N. Mark Dearden

Authors
  1. J. Douglas Miller
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  2. N. Mark Dearden
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Editor information

Editors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Yamaguchi University School of Medicine, 1144 Kogushi, Ube, Yamaguchi, 755, Japan

    Hiroshi Takeshita M.D. (Emeritus Professor) (Emeritus Professor)

  2. Laboratory for Experimental Brain Research, Head Research Departments, Lund Hospital, S-221 85, Lund, Sweden

    Bo K. Siesjö M.D. (Director) (Director)

  3. Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, EH4 2XU, Edinburgh, Scotland

    James Douglas Miller M.D. (Professor for Surgical Neurology and Chairman) (Professor for Surgical Neurology and Chairman)

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© 1991 Springer-Verlag Tokyo

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Miller, J.D., Dearden, N.M. (1991). Management of Brain Edema in Head Injury. In: Takeshita, H., Siesjö, B.K., Miller, J.D. (eds) Advances in Brain Resuscitation. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68538-8_17

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  • DOI: https://doi.org/10.1007/978-4-431-68538-8_17

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68540-1

  • Online ISBN: 978-4-431-68538-8

  • eBook Packages: Springer Book Archive

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