Presenter

NAILA
Assigned by
Mam FARIDA
 Objectives
 At the end of this presentation the students will be able to:
 Define Cerebral Edema.
 Explain pathophysiology and Causes.
 Describe Sign and symptoms.
 Discuss different types of Cerebral Edema.
 Explain Assessment and Diagnostic finding.
 Describe medical, surgical and nursing management of
cerebral edema.

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 Cerebral Edema
Definition .
• It is an excess accumulation
of fluid (edema) in
the intracellular
or extracellular spaces of
the brain.
• Also known as brain edema,
brain swelling, and wet brain.

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 Pathophysiology
• The pathophysiology of cerebral edema is complex, it initiate as
a results of accumulation of fluid in the brain’s intracellular and
extracellular spaces.
• There are four fluid compartments in the brain. blood (cerebral
vessels), cerebrospinal fluid (CSF) (ventricular system),
interstitial fluid (brain parenchyma) and intracellular fluid
(neurons and glial cells).
• There is tight control of movement of fluid and solute particles
from one compartment to other. When these movement disrupts
it will cause cerebral edema.
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 Sign and Symptoms
• Nausea,

• Vomiting,

• Blurred Vision

• Faintness

• Confusion

• Headache that is sudden

and severe

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 Causes
Traumatic brain injury Non-traumatic brain injury
• Falls • Blood clot in the
cerebral vessel
• Vehicular accidents • Brain hemorrhage
• Being hit by a blunt • Brain infections –
meningitis, encephalitis
object • Brain tumors
• Crashing into an object • Severe hypertension

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 Cytotoxic
• It occur due to a disruption in cellular metabolism
that impairs ATP dependent Na/k pump in the glial
cell membrane leads to cellular influx of Na and
water which result to into edema.

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 Vasogenic
• This type of edema seen in response to trauma, tumor, and
cerebral ischemia.

• It breakdown the tight endothelial junction and disturb

blood brain barrier (BBB) which increase vascular
permeability and result into a edema.

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 Hydrostatic
• This form of cerebral edema is seen in acute hypertension.

• It result from disturbance of cerebral blood circulation

with direct transmission of pressure to cerebral capillary
with transudation of fluid into extra cellular fluid (ECF)

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How Is Cerebral edema Diagnosed?

Common exams and tests used in the diagnosis include:

• Head and neck exam
• Neurologic exam
• CT scan of the head to identify the extent and location of
the swelling
• MRI of the head to identify the extent and location of the
swelling
• Blood tests to check for causes of the swelling

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 Medical Management

• Medication
• Doctors may prescribe you
medication to help reduce
swelling and prevent blood
clots.
• Diuretic to decrease fluid
volume, corticosteroids to
suppress the immune
system etc.

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 Cont…
• Osmotherapy
• Osmotherapy is a technique
meant to draw water out of the
brain.
• This is done using osmotic
agents such as mannitol, or
high-salt saline.
• Osmotic therapy also helps
improve blood circulation.
• This will help reduce swelling
and ICP in the skull.

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 Cont..
• Hyperventilation
• It help lower your ICP.
• Hyperventilation causes
you to exhale more than
you inhale, lowering the
amount of carbon dioxide
in your bloodstream.
• Controlling this process
lowers the blood flow in
your brain and reduces
ICP.

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 Cont…
• Hypothermia

• Lowering the body

temperature decreases
metabolism in the brain
and can also reduce
swelling.

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 Surgical Management
• In more severe cases of cerebral edema, you may need
surgery to relieve ICP. This surgery could mean removing
part of the skull or removing the source of the swelling,
such as in the case of a tumor.

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 Nursing Management
• Monitor vitals sign closely

• Hyperventilation to provide adequate oxygenated blood

and decrease carbon dioxide

• Maintain patent airway

• Administered medication as ordered.

• Asses and documents neurological status

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 References
• Raslan A, Bhardwaj A (2007). "Medical management of cerebral
edema". Neurosurgical Focus.

• Qureshi AI, Suarez JI (2000). "Use of hypertonic saline solutions in

treatment of cerebral edema and intracranial hypertension".

• Heiss JD, Papavassiliou E, Merrill MJ, Nieman L, Knightly JJ,

Walbridge S, Edwards NA, Oldfield EH (1996). "Mechanism of
dexamethasone suppression of brain tumor-associated vascular
permeability in rats.

• Van Osta A, Moraine JJ, Mélot C, Mairbäurl H, Maggiorini M, Naeije

R (2005).

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