Book contents
- Neurocritical Care
- Neurocritical Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 The Neurological Assessment of the Critically Ill Patient
- Chapter 2 Cerebral Blood Flow Physiology and Metabolism in the Neurocritical Care Unit
- Chapter 3 Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit
- Chapter 4 Hypothermia in the Neurocritical Care Unit: Physiology and Applications
- Chapter 5 Analgesia, Sedation, and Paralysis in the Neurocritical Care Unit
- Chapter 6 Airway Management and Mechanical Ventilation in the Neurocritical Care Unit
- Chapter 7 Neuropharmacology in the Neurocritical Care Unit
- Chapter 8 Intracranial Monitoring in the Neurocritical Care Unit
- Chapter 9 Electrophysiologic Monitoring in the Neurocritical Care Unit
- Chapter 10 The Role of Transcranial Doppler as a Monitoring Tool in the Neurocritical Care Unit
- Chapter 11 Ischemic Stroke in the Neurocritical Care Unit
- Chapter 12 Intracerebral Hemorrhage in the Neurocritical Care Unit
- Chapter 13 Management of Cerebral Venous Thrombosis in the Neurocritical Care Unit
- Chapter 14 Subarachnoid Hemorrhage in the Neurocritical Care Unit
- Chapter 15 Status Epilepticus in the Neurocritical Care Unit
- Chapter 16 Neuromuscular Disorders in the Neurocritical Care Unit
- Chapter 17 Management of Head Trauma in the Neurocritical Care Unit
- Chapter 18 Management of Autoimmune Encephalitis in the Neurocritical Care Unit
- Chapter 19 Management of Cerebral Salt-Wasting Syndrome and Syndrome of Inappropriate Antidiuresis in the Neurocritical Care Unit
- Chapter 20 Brain Death in the Neurocritical Care Unit
- Chapter 21 Neuroterrorism and Drug Overdose in the Neurocritical Care Unit
- Chapter 22 Infections of the Central Nervous System in the Neurocritical Care Unit
- Chapter 23 Management of the Spinal Cord Injury in the Neurocritical Care Unit
- Chapter 24 Postoperative Management in the Neurocritical Care Unit
- Chapter 25 Ethical Considerations in the Neurocritical Care Unit
- Chapter 26 Pulmonary Consult: Management of Severe Hypoxia in the Neurocritical Care Unit
- Chapter 27 Management of Refractory Arrhythmias in the Neurocritical Care Unit
- Chapter 28 An Infectious Diseases Consult in the Neurocritical Care Unit
- Chapter 29 A Nephrology Consult in the Neurocritical Care Unit
- Chapter 30 Management of Hepatic Encephalopathy in the Neurocritical Care Unit
- Chapter 31 Hypoxic Encephalopathy in the Neurocritical Care Unit
- Chapter 32 Management of Delirium in the Neurocritical Care Unit
- Chapter 33 Generalized Weakness in the Neurocritical Care Unit
- Chapter 34 Management of Severely Brain-Injured Patients Recovering from Coma in the Neurocritical Care Unit
- Chapter 35 Acute Demyelinating Disorders in the Neurocritical Care Unit
- Chapter 36 Building a Case for a Neurocritical Care Unit
- Chapter 37 Neurointensive (NCCU) Care Business Planning
- Index
- References
Chapter 3 - Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit
Published online by Cambridge University Press: 24 July 2019
Edited by
Book contents
- Neurocritical Care
- Neurocritical Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 The Neurological Assessment of the Critically Ill Patient
- Chapter 2 Cerebral Blood Flow Physiology and Metabolism in the Neurocritical Care Unit
- Chapter 3 Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit
- Chapter 4 Hypothermia in the Neurocritical Care Unit: Physiology and Applications
- Chapter 5 Analgesia, Sedation, and Paralysis in the Neurocritical Care Unit
- Chapter 6 Airway Management and Mechanical Ventilation in the Neurocritical Care Unit
- Chapter 7 Neuropharmacology in the Neurocritical Care Unit
- Chapter 8 Intracranial Monitoring in the Neurocritical Care Unit
- Chapter 9 Electrophysiologic Monitoring in the Neurocritical Care Unit
- Chapter 10 The Role of Transcranial Doppler as a Monitoring Tool in the Neurocritical Care Unit
- Chapter 11 Ischemic Stroke in the Neurocritical Care Unit
- Chapter 12 Intracerebral Hemorrhage in the Neurocritical Care Unit
- Chapter 13 Management of Cerebral Venous Thrombosis in the Neurocritical Care Unit
- Chapter 14 Subarachnoid Hemorrhage in the Neurocritical Care Unit
- Chapter 15 Status Epilepticus in the Neurocritical Care Unit
- Chapter 16 Neuromuscular Disorders in the Neurocritical Care Unit
- Chapter 17 Management of Head Trauma in the Neurocritical Care Unit
- Chapter 18 Management of Autoimmune Encephalitis in the Neurocritical Care Unit
- Chapter 19 Management of Cerebral Salt-Wasting Syndrome and Syndrome of Inappropriate Antidiuresis in the Neurocritical Care Unit
- Chapter 20 Brain Death in the Neurocritical Care Unit
- Chapter 21 Neuroterrorism and Drug Overdose in the Neurocritical Care Unit
- Chapter 22 Infections of the Central Nervous System in the Neurocritical Care Unit
- Chapter 23 Management of the Spinal Cord Injury in the Neurocritical Care Unit
- Chapter 24 Postoperative Management in the Neurocritical Care Unit
- Chapter 25 Ethical Considerations in the Neurocritical Care Unit
- Chapter 26 Pulmonary Consult: Management of Severe Hypoxia in the Neurocritical Care Unit
- Chapter 27 Management of Refractory Arrhythmias in the Neurocritical Care Unit
- Chapter 28 An Infectious Diseases Consult in the Neurocritical Care Unit
- Chapter 29 A Nephrology Consult in the Neurocritical Care Unit
- Chapter 30 Management of Hepatic Encephalopathy in the Neurocritical Care Unit
- Chapter 31 Hypoxic Encephalopathy in the Neurocritical Care Unit
- Chapter 32 Management of Delirium in the Neurocritical Care Unit
- Chapter 33 Generalized Weakness in the Neurocritical Care Unit
- Chapter 34 Management of Severely Brain-Injured Patients Recovering from Coma in the Neurocritical Care Unit
- Chapter 35 Acute Demyelinating Disorders in the Neurocritical Care Unit
- Chapter 36 Building a Case for a Neurocritical Care Unit
- Chapter 37 Neurointensive (NCCU) Care Business Planning
- Index
- References
Summary
Cerebral edema is a common challenge in the intensive care unit, and often occurs during trauma, malignant ischemic stroke, or hemorrhage. The condition describes a relative increase in the brain’s water content, as a result of pathologic fluid and solute movement between intracranial compartments. The brain’s four intracranial compartments are intracellular, extracellular, intravascular, and cerebrospinal fluid. Barriers separate each of these compartments, and allow each to maintain their own electrochemical environments. In acute brain injury, disruptions of these barriers may lead to cerebral edema formation [1,2].
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- Chapter
- Information
- Neurocritical Care , pp. 19 - 27Publisher: Cambridge University PressPrint publication year: 2019
References
Xi, G, Keep, RF, Hoff, JT (2002). Pathophysiology of brain edema formation. Neurosurg Clin N Am 13(3): 371–383.CrossRefGoogle ScholarPubMed
Khanna, A, Kahle, KT, Walcott, BP, Gerzanich, V, Simard, JM (2014). Disruption of ion homeostasis in the neurogliovascular unit underlies the pathogenesis of ischemic cerebral edema. Transl Stroke Res 5(1): 3–16.CrossRefGoogle ScholarPubMed
Marmarou, A (2007). A review of progress in understanding the pathophysiology and treatment of brain edema. Neurosurg Focus 22(5):E1.Google ScholarPubMed
Simard, JM, Kent, TA, Chen, M, Tarasov, KV, Gerzanich, V (2007). Brain oedema in focal ischaemia: molecular pathophysiology and theoretical implications. Lancet Neurol 6(3):258–268.Google Scholar
Nilius, B, Droogmans, G (2001). Ion channels and their functional role in vascular endothelium. Physiol Rev 81: 1415–1459.Google Scholar
Strange, K (1992). Regulation of solute and water balance and cell volume in the central nervous system J Am Soc Nephrol 3: 12–27.Google Scholar
Raslan, A, Bhardwaj, A (2007). Medical management of cerebral edema. Neurosurg Focus 22(5): E12.Google Scholar
Betz, AL, Iannotti, F, Hoff, JT (1989). Brain edema: a classification based on blood-brain barrier integrity. Cerebrovasc Brain Metab Rev 1: 133–154.Google Scholar
Arch, AE, Seth, KN (2014). Malignant cerebral edema after large anterior circulation infarction: a review. Curr Treat Options Cadiovasc Med 16(1): 275.Google Scholar
Mayer, SA, Coplin, WM, Raps, EC (1999). Cerebral edema, intracranial pressure, and herniation syndromes. J Stroke Cerebrovasc Dis 8: 183–191.CrossRefGoogle ScholarPubMed
Lescot, T, Abdennour, L, Boch, AL, Puybasset, L (2008). Treatment of intracranial hypertension. Curr Opin Crit Care 14: 129–134.Google Scholar
Rosner, MJ, Coley, IB (1986). Cerebral perfusion pressure, intracranial pressure, and head elevation. J Neurosurg 65: 636–641.Google Scholar
Koh, MG, Phan, TG, Atkinson, JL, Wijdicks, EF (2000). Neuroimaging in deteriorating patients with cerebellar infacts and mass effect. Stroke 31: 2062–2067.CrossRefGoogle Scholar
Ryoo, JV, Na, DG, Kim, SS, et al. (2004). Malignant middle cerebral artery infarction in hyperacute ischemic stroke: evaluation with multiphasic perfusion computed tomography maps. J Comput Assist Tomogr 28: 55–62.Google Scholar
Yoo, AJ, Sheth, KN, Kimberly, WT, et al. (2013). Validating imaging biomarkers of cerebral edema in patients with severe ischemic stroke. J Stroke Cerebrovasc Dis 22: 742–749.CrossRefGoogle ScholarPubMed
Bardutzsky, J, Schwab, S (2007). Antiedema therapy in ischemic stroke. Stroke 38: 3084–3094.CrossRefGoogle Scholar
Chestnut, RM, Temkin, N, Carney, N, et al. (2012). A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367(26): 2471–2481.Google Scholar
Muizelaar, JP, Marmarou, A, Ward, JD, et al. (1991). Adverse effects of prolonged hyperventilation in patients with severe head injury: A randomized clinical trial. J Neurosurg 75: 731–739.Google Scholar
Diringer, MN, Zazulia, AR (2004). Osmotic therapy: fact or fiction? Neurocrit Care 1: 219–234.CrossRefGoogle ScholarPubMed
Harukuni, I, Kirsch, J, Bhardwaj, A (2002). Cerebral resuscitation: role of osmotherapy. J Anesth 16: 229–237.Google Scholar
Diringer, MN, Scalfani, MT, Zazulia, AR, Videen, TO, Dhar, R (2011). Cerebral hemodynamic and metabolic effects of equi-osmolar doses mannitol and 23.4% saline in patients with edema following large ischemic stroke. Neurocrit Care 14(1): 11– 17.Google Scholar
Bhardwaj, A, Ulatowski, JA (2004). Hypertonic saline solutions in brain injury. Curr Opin Crit Care 10: 126–31.Google Scholar
Bhardwaj, A, Ulatowski, JA (1999). Cerebral edema: hypertonic saline solutions. Curr Treat Opt Neurol 1: 179–187.CrossRefGoogle ScholarPubMed
Cremer, OL, Moons, KG, Bouman, EA, et al. (2001). Long-term propofol infusion and cardiac failure in adult head-injured patients. Lancet 357: 117–118.Google Scholar
Hypothermia after Cardiac Arrest Study Group (2002). Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346: 549–556.CrossRefGoogle Scholar
Wu, TC, Grotta, JC (2013). Hypothermia for acute ischaemic stroke. Lancet Neurol 12(3): 275–284.CrossRefGoogle ScholarPubMed
Florczak-Rzepka, M, Grond-Ginsbach, C, Montaner, J, Steiner, T (2012). Matrix metalloproteinases in human spontaneous intracerebral hemorrhage: an update. Cerebrovasc Dis 34(4): 249–262.Google Scholar
Vahedi, K, Hofmeijer, J, Juettler, E, et al. (2007). DECIMAL, DESTINY, and HAMLET investigators. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomized controlled trials. Lancet Neurol 6(3): 215–222.CrossRefGoogle Scholar
Li, N, Liu, YF, Ma, L, et al. (2013). Association of molecular markers with perihematomal edema and clinical outcome in intracerebral hemorrhage. Stroke 44(3): 658–663.CrossRefGoogle ScholarPubMed
Walcott, BP, Kahle, KT, Simard, JM (2012). Novel treatment targets for cerebral edema. Neurotherapeutics 9(1): 65– 72.CrossRefGoogle ScholarPubMed
Simard, JM, Geng, Z, Silver, FL, et al. (2012). Does inhibiting Sur1 complement rt-PA in cerebral ischemia? Ann N Y Acad Sci 1268: 95–107.Google Scholar
Kunte, H, Schmidt, S, Eliasziw, M, et al. (2007). Sulfonylureas improve outcome in patients with type 2 diabetes and acute ischemic stroke. Stroke 38(9): 2526–2530.Google Scholar
Kunte, H, Busch, MA, Trostdorf, K, et al. (2012). Hemorrhagic transformation of ischemic stroke in diabetics on sulfonylureas. Ann Neurol 72(5): 799–806.Google Scholar
Badaut, J, Lasbennes, F, Magistretti, PJ, Regli, L (2002). Aquaporins in brain distribution, physiology, and pathophysiology. J Cereb Blood Flow Metab 22(4): 367–378.Google Scholar
Chu, H, Tang, Y, Dong, Q (2013). Protection of vascular endothelial growth factor to brain edema following intracerebral hemorrhage and its involved mechanisms: effect of Aquaporin-4. PLoS One 8(6):e66051.Google Scholar
Stein, DG (2008). Progesterone exerts neuroprotective effects after brain injury. Brain Res Rev 57(2): 386–397.Google Scholar