What is cytotoxic Oedema?
Cytotoxic edema is defined as the premorbid cellular process, otherwise known as cellular edema, oncotic cell swelling, or oncosis, whereby extracellular Na+ and other cations enter into neurons and astrocytes and accumulate intracellularly, in part due to failure of energy-dependent mechanisms of extrusion.
How does vasogenic edema occur?
Vasogenic. Extracellular brain edema, or vasogenic edema, is caused by an increase in the permeability of the blood-brain barrier. The blood-brain barrier consists of astrocytes and pericytes joined together with adhesion proteins producing tight junctions.
Why does cytotoxic edema occur?
Cytotoxic edema is the result of cells being unable to maintain ATP-dependent sodium/potassium (Na+/K+) membrane pumps which are responsible for high extracellular and low intracellular Na+ concentration 6.
What is cytotoxic medication used for?
Cytotoxic drugs (sometimes known as antineoplastics) describe a group of medicines that contain chemicals which are toxic to cells, preventing their replication or growth, and so are used to treat cancer. They can also be used to treat a number of other disorders such as rheumatoid arthritis and multiple sclerosis.
Why does vasogenic Oedema only affect white matter?
Vasogenic cerebral edema iinvolves the escape of fluids and proteins from the vascular system into the extracellular space. Because the fluid can flow along fiber tracts, the swelling may be greater in white matter than in gray matter.
What are the different types of cerebral edema?
Cerebral edema can result from a variety of derangements. The major types include vasogenic, cellular, osmotic, and interstitial. Through these mechanisms, cerebral edema stems from tumor, trauma, hypoxia, infection, metabolic derangements, or acute hypertension.
How is vasogenic edema treated?
Corticosteroids – Corticosteroids lower intracranial pressure primarily in vasogenic edema because of their beneficial effect on the blood vessel. They have been less effective in cytotoxic edema, and are not recommended in treatment of edema secondary to stroke or haemorrhage.
How is osmotherapy done?
This is accomplished by intravenous administration of osmotic agents which increase serum osmolality in order to shift excess fluid from intracellular or extracellular space of the brain to intravascular compartment. The resulting brain shrinkage effectively reduces intracranial volume and decreases ICP.
Why is vasogenic edema clinically important?
The vasogenic edema that surrounds many brain tumors contributes significantly to morbidity. This edema results from disruption of the blood-brain barrier, allowing protein-rich fluid to accumulate in the extracellular space [1].