Emergency treatment for swelling of the brain and treatment tactics

The swelling of the brain tissue is a reaction to the action of pathogenic factors. The specific structure of the brain tissue and features of the brain functions to the development of cerebral edema, the treatment of which is necessary from the earliest symptoms. The main manifestation of pathology is increased intracranial pressure( ICP).

With a slight increase in ICP, compensatory mechanisms that support normal brain function are triggered. Further increase in ICP leads to compression of small vessels, sinuses of the dura mater. Compression of tissues in turn becomes the cause of cerebral ischemia.

Classification of

Before the removal of cerebral edema, establish the degree of ICP.With a moderate increase in ICP, it does not exceed 20 mm Hg. For a severe degree, high rates of ICP( more than 40 mm Hg) are characteristic. For a patient with high ICP, the risk of paralysis and neuronal damage increases. The degree of reversibility of pathological processes depends on how much the cerebral blood flow is reduced.

There are several types of edema:

• hydrocephalus;
• osmotic;
• is vasogenic;
• is ischemic;
• is cytotoxic.

The cause of hydrocephalic edema are inflammation and hemorrhages in the ventricles of the brain. Vasogenous edema develops against the background of metabolic disorders, arterial hypertension, high fever, poisoning with carbon dioxide.

In case of hemodynamic disorders, osmolar solutions load develop osmotic form of edema. The reason for the ischemic type of edema is the inadequate supply of oxygen to tissues. Cytostatic edema develops with viral infections, poisoning.

Depending on the cause, the doctor decides how to treat cerebral edema. As a rule, untimely treatment leads to cessation of outflow of cerebrospinal fluid, vascular disturbances, which leads to irreversible processes and death of the patient.

First aid

If a patient develops cerebral edema, emergency care consists in the simultaneous carrying out of diagnostic and therapeutic activities. Patients are transported with an increased head end of the stretcher. In severe cases, intubation and connection of the patient to the artificial respiration apparatus are shown. Patients are assigned:

• etiotropic therapy aimed at the cause of edema;
• preparations for correction of intracranial pressure;
• , when a patient is connected to the ventilator, sedative agents are introduced( Sibazon);
• for the treatment of convulsive syndrome is injected with thiopental;
• surgical intervention with hematoma, abscess or concussion;
• in case of a violation of the outflow of liquor, an operation is indicated for setting the cerebrospinal fluid.

When hypoxia, high temperature, increase in potassium in the blood and other factors that cause metabolic disorders, conduct therapy that is aimed at normalizing hemodynamics. The earlier intensive therapy is started, the more likely the patient is to recover.

Tactics of treatment for edema of the brain

For the purpose of correction of hemodynamic disorders, patients are prescribed drugs with edema of the brain that normalize blood pressure. At low rates of systolic pressure, patients are injected with colloidal solutions( Refortan, Stabisol).In some cases, the introduction of hyperosmolar solutions( Sorbilact) is shown.

Important! With low systolic pressure, intravenous drip hypo-osmolar solutions and glucose are not administered. When hypoglycemic coma, 40% glucose solution within 20-40 ml is permissible.

If solutions are not effective, prescribe vasopressor drugs( Dopamine, Noradrenaline, Mezaton).In a state of shock, corticosteroids are administered( Prednisilon, Methylprednisolone).If the patient develops osmotic edema of the brain, osmotic diuretics( Mannitol) are used. Showing other diuretics( Furosemide, Lasix).

With arterial hypertension, patients are treated with magnesium sulfate, which has a mild hypotensive effect. The drug is not prescribed for kidney failure. Vasogenic edema is effectively eliminated by drugs with angioprotective action. For this purpose, L-lysine escinate is widely used. The medicine restores the elasticity of the vessels, reduces swelling.

To eliminate tissue ischemia, drugs that improve metabolism are used( Mexidol).It should be noted that solutions and tablets from cerebral edema with nootropic action in the acute stage are not prescribed. Pyracetam, Nootropil, Actovegin and other nootropic drugs are prescribed after the elimination of the cause that led to hydrocephalus.

In conclusion, it should be noted that edematous syndrome can lead to a persistent disruption of blood flow in the brain tissues. This, in turn, leads to dysfunction of the organs and systems of the body. Timely elimination of the cause of edematous syndrome is the main task for neuropathologists. Therefore, with the increase of hydrocephalus, doctors recommend that as soon as possible to treat cerebral edema.