Pathophysiology and Clinics of the Brain Oedema

Overview

Brain oedema is defined as an abnormal accumulation of fluid in the brain tissue accompanied by an increasedvolume of the brain. It results in the intracranial hypertension directly endangering the patient’s life. No causaltreatment of the brain oedema is known at present. The brain oedema is not a disease, but it is a symptom of variousclinical states. That is why experimental studies of its pathophysiology become the centre of attention. Though theclassification of brain oedema according to the pathogenesis is still used (the vasogenic type - resulting from theincreased permeability of blood-brain barrier; the cytotoxic type - caused by the cell metabolism impairment), recentpapers has shown a definite retraction from such categorisation. It has been shown that neither type of brain oedemacomes alone, but both can occur simultaneously during the development of the pathological state of the brain. Themost important appears to be the primary insult. It affects the state of blood-brain barrier and brings about thevasogenic extracellular oedema or it can influence the cell metabolism with subsequent cytotoxic, cellular oedema.Categorisation of oedema into extracellular and cellular reflects more precisely the impairment of the homeostasisof the internal environment of the brain.Contemporary viewon the classification and pathophysiologicalmechanismsof the brain oedema is discussed in our review.

Key words:
intracranial hypertension, brain oedema, internal environment of the brain.